JACK LOPEZ

BEND, OR
NPI1750858858
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  16-10-11)
Enumeration Date2018-10-26
Last Update Date2018-10-26
Business Address
JACK LOPEZ CADCII
155 NE REVERE AVE STE 150
BEND, OR 97701-4147
Phone number: 541-617-4544
Mailing Address
JACK LOPEZ CADCII
155 NE REVERE AVE STE 150
BEND, OR 97701-4147
Phone number: 541-617-4544
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