GLEN MARTIN LOPEZ

GLENDORA, CA
NPI1942567946
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy167G00000X Licensed Psychiatric Technician
(Licence: CA  PT 36343)
Enumeration Date2012-04-13
Last Update Date2012-04-13
Business Address
-- GLEN MARTIN LOPEZ LPT
1160 S GRAND AVE
GLENDORA, CA 91740-5000
Phone number: 626-335-5980
Mailing Address
-- GLEN MARTIN LOPEZ LPT
851 S SUNSET AVE APT 186
WEST COVINA, CA 91790-5510
Phone number: 626-234-6348