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Individual

MEGAN ALICIA LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
5450 VICTORIA AVE, RIVERSIDE, CA 92506-3362
(951) 788-7203
Mailing address
4310 SUNNYSIDE DR, RIVERSIDE, CA 92506-2080
(951) 315-9621

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
08/18/2020
Last updated
08/18/2020
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