KEITH ALBERT LOPEZ

ANACONDA, MT
NPI1457610214
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT  14111)
Enumeration Date2012-05-14
Last Update Date2012-05-14
Business Address
-- KEITH ALBERT LOPEZ LAC
307 E PARK AVE SUITE 207B
ANACONDA, MT 59711-2320
Phone number: 406-563-7197
Mailing Address
-- KEITH ALBERT LOPEZ LAC
T9 FORT MISSOULA
MISSOULA, MT 59804-7298
Phone number: 406-532-8400