Individual
EDGAR LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1831 SCHUSTER AVE, JOLIET, IL 60433-9551
(815) 585-3984
Mailing address
1831 SCHUSTER AVE, JOLIET, IL 60433-9551
(815) 585-3984
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.009139
IL
Other
Enumeration date
01/21/2021
Last updated
01/21/2021
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