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General NPI Number Information
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NPI Number | 1972461770
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Entity Type | Individual
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Provider Name | CORIANNE KATHLEEN LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 6410 S KINGS RANCH RD STE 4
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City | GOLD CANYON
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State | AZ
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Zip | 85118-7211
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Country | US
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Telephone | 480-982-7948
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Fax | 480-982-9145
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Provider Business Mailing Address
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Address Line | 2500 S POWER RD STE 123
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City | MESA
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State | AZ
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Zip | 85209-6688
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Country | US
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Telephone | 480-218-1344
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Fax | 480-218-1356
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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 | LPT-034605
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License Number State | AZ
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