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1053908897
MARICEL NOEMI LOPEZ
GOSHEN, IN
NPI
1053908897
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: IN 1096964)
Enumeration Date
2020-12-28
Last Update Date
2020-12-28
Business Address
MARICEL NOEMI LOPEZ RD, LD
200 HIGH PARK AVE
GOSHEN, IN 46526-4810
Phone number: 574-364-2868
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Mailing Address
MARICEL NOEMI LOPEZ RD, LD
14070 KIMBERLY LN
MIDDLEBURY, IN 46540-9727
Phone number: 574-612-7563
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