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NPI Code Detail

MEDICARE: JOALDA LOPEZ PTA

MEDICARE:   JOALDA  LOPEZ  PTA
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
1225200000XPhysical Therapy Assistant1530NM

General Provider Information

NPI Number : 1700353042
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOALDA LOPEZ PTA
Provider Business Mailing Address
First Line : 7849 TRAMWAY BLVD NE STE A
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87122-2529
Country : US
Telephone Number : 505-821-3831
Fax Number :
Provider Business Practice Location Address
First Line : 7849 TRAMWAY BLVD NE STE A
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87122-2529
Country : US
Telephone Number : 505-821-3831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2018
Last Update Date : 10/24/2018

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Directions to “ JOALDA LOPEZ PTA” Practice Location

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