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1013055979
IVELISSE SOCORRO LOPEZ
JACKSONVILLE, FL
NPI
1013055979
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL 3961)
Enumeration Date
2007-02-02
Last Update Date
2007-07-08
Business Address
-- IVELISSE SOCORRO LOPEZ P.T.
3901 UNIVERSITY BLVD S
JACKSONVILLE, FL 32216-4312
Phone number: 904-858-7200
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Mailing Address
-- IVELISSE SOCORRO LOPEZ P.T.
12979 FRINGETREE DR W
JACKSONVILLE, FL 32246-1152
Phone number: 904-982-5007
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