Individual
GEMMA JUSTICE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
36453 N GANTZEL RD STE 101, SAN TAN VALLEY, AZ 85140-7340
(480) 636-1225
(480) 636-8890
Mailing address
4881 E GRANT RD STE 101, TUCSON, AZ 85712-2704
(520) 829-6776
(520) 829-6661
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
7208
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
577172
—
AZ
Enumeration date
09/17/2018
Last updated
01/28/2021
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