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1497112866
LAURENCIO LOPEZ
FORT CAMPBELL, KY
NPI
1497112866
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: TX 1130762)
Enumeration Date
2016-01-15
Last Update Date
2016-01-15
Business Address
-- LAURENCIO LOPEZ
650 JOEL DR
FORT CAMPBELL, KY 42223-5318
Phone number: 270-798-8500
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Mailing Address
-- LAURENCIO LOPEZ
1570 COBRA LN
CLARKSVILLE, TN 37042-0706
Phone number: 850-240-2581
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