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1417257221
KELLEN K LOPEZ
LAS VEGAS, NV
NPI
1417257221
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2010-10-26
Last Update Date
2010-10-26
Business Address
Mr. KELLEN K LOPEZ
20 E SERENE AVE UNIT 312
LAS VEGAS, NV 89123-3770
Phone number: 808-258-6521
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Mailing Address
Mr. KELLEN K LOPEZ
20 E SERENE AVE UNIT 312
LAS VEGAS, NV 89123-3770
Phone number: 808-258-6521
Copy
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