Individual
HORTENCIA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1714 NW CROSBY PARK BLVD, LAWTON, OK 73505-2925
(580) 917-9798
Mailing address
1714 NW CROSBY PARK BLVD, LAWTON, OK 73505-2925
(580) 917-9798
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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