Healthcare Provider Details

I. General information

NPI: 1821509332
Provider Name (Legal Business Name): LOPEZ HOUSE CALLS CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 THUNDERHEAD TRAIL
SONOITA AZ
85637
US

IV. Provider business mailing address

PO BOX 213
SONOITA AZ
85637-0213
US

V. Phone/Fax

Practice location:
  • Phone: 520-357-1711
  • Fax:
Mailing address:
  • Phone: 520-357-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ANGELA LOPEZ
Title or Position: CO-OWNER
Credential: DC
Phone: 520-357-1711