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General NPI Number Information
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NPI Number | 1477309722
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Entity Type | Individual
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Provider Name | JOE LOPEZ JR. DPT
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Gender | Male
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Dates
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Enumeration Date | 04/27/2024
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 3541 LYNDALE AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-4159
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Country | US
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Telephone | 612-824-1829
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Fax | 612-823-3808
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Provider Business Mailing Address
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Address Line | 106 BEDFORD ST SE
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-3526
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Country | US
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Telephone | 720-298-7478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13405
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License Number State | MN
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