Jessica Lopez

NPI #1871979849 in Eagle, Idaho

Provider Information

NPI Number: 1871979849
Entity Type: Individual
Name: Jessica Lopez
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Jul 31, 2015
Last Updated: Jul 31, 2015

Practice Location

Address: 150 E RIVERSIDE DR
Address 2: SUITE 100
City: Eagle
State: Idaho
ZIP Code: 83616-6087
Phone: (208) 938-3511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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