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General NPI Number Information
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NPI Number | 1669858163
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Entity Type | Individual
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Provider Name | JESSICA LOPES
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Gender | Female
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Dates
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Enumeration Date | 08/06/2015
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Last Update Date | 08/06/2015
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Provider Practice Location Address
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Address Line | 119 WASHINGTON ST
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City | NORWELL
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State | MA
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Zip | 02061-1728
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Country | US
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Telephone | 781-871-9500
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Fax | 781-871-9525
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Provider Business Mailing Address
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Address Line | 210 COMMERCE WAY SUITE 120
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City | PORTSMOUTH
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State | NH
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Zip | 03801-8200
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Country | US
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Telephone | 603-427-8066
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Fax | 603-501-0495
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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 | 21823
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License Number State | MA
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