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NPI Code Detail

MEDICARE: VALERIE ALEXANDRA LOPEZ LMT

MEDICARE: VALERIE ALEXANDRA LOPEZ LMT
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
1225700000XMassage TherapistMT-23366AZ

General Provider Information

NPI Number : 1639748270
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE ALEXANDRA LOPEZ LMT
Provider Business Mailing Address
First Line : 3201 W PEORIA AVE STE B301
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4618
Country : US
Telephone Number : 602-767-7788
Fax Number :
Provider Business Practice Location Address
First Line : 3201 W PEORIA AVE STE B301
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4618
Country : US
Telephone Number : 602-767-7788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2021
Last Update Date : 06/18/2021

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Directions to “ VALERIE ALEXANDRA LOPEZ LMT” Practice Location

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