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1346066842
CHRIS BRIAN LOPEZ DOMINGO
WOODBURY, MN
NPI
1346066842
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 3500)
Enumeration Date
2024-11-29
Last Update Date
2024-11-29
Business Address
CHRIS BRIAN LOPEZ DOMINGO ATC
155 RADIO DR
WOODBURY, MN 55125-2619
Phone number: 952-831-8742
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Mailing Address
CHRIS BRIAN LOPEZ DOMINGO ATC
18423 97TH PL N
MAPLE GROVE, MN 55311-7708
Phone number: 320-291-3569
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