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NPI Code Detail

MEDICARE: YAQUELIN LOPEZ GARCIA DPT

MEDICARE: YAQUELIN LOPEZ GARCIA DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305216815VA

General Provider Information

NPI Number : 1760228761
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAQUELIN LOPEZ GARCIA DPT
Provider Business Mailing Address
First Line : 3900 MAZE RUNNER DR APT 201
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-3642
Country : US
Telephone Number : 804-519-7390
Fax Number :
Provider Business Practice Location Address
First Line : 5205 COMMONWEALTH CENTRE PKWY
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-2623
Country : US
Telephone Number : 804-977-2770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2024
Last Update Date : 12/13/2024

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