IVAN LOPEZ

MEDFORD, OR
NPI1700655123
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Additional Taxonomies175T00000X Peer Specialist
Enumeration Date2023-12-27
Last Update Date2024-06-04
Business Address
IVAN LOPEZ
300 W MAIN ST
MEDFORD, OR 97501-2756
Phone number: 541-816-1218
Mailing Address
IVAN LOPEZ
300 W MAIN ST
MEDFORD, OR 97501-2756
Phone number: 541-816-1218
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