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Individual

XAVIER LOPEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7115 DURAND AVE STE H, MOUNT PLEASANT, WI 53177-1971
(262) 762-4844
Mailing address
2625 BUTTERFIELD RD STE 301N, OAK BROOK, IL 60523-1266
(630) 468-1824

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5469-12
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5469-12
CHIROPRACTIC LICENSE
WI
Enumeration date
07/19/2019
Last updated
01/18/2021
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