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1104952209
JORGE LUIS LOPEZ
FORT CARSON, CO
NPI
1104952209
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2007-02-26
Last Update Date
2007-07-08
Business Address
Mr. JORGE LUIS LOPEZ PA
1650 COCHRANE CIR ATTN CREDENTIALS OFFICE
FORT CARSON, CO 80913-4603
Phone number: 719-526-7844
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Mailing Address
Mr. JORGE LUIS LOPEZ PA
EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC 1650 COCHRANE CIRCLE, ATTN CREDENTIALS OFFICE
COLORADO SPINGS, CO 80913-4604
Phone number: 719-526-7844
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