Andrea Lynn Lopez, ATC
Specialist/Technologist, Athletic Trainer in West Lafayette, IN. Individual provider (NPI-1).
NPI number1720163348
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1720163348
- Entity type
- Individual (NPI-1)
- Name
- Andrea Lynn Lopez
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 25, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 36001327A | IN | Yes |
Practice location
900 N. University AveRoom B63
West Lafayette, IN 47907
Phone 765-494-3245
Mailing address
3860 Ledyard St.West Lafayette, IN 47906
Phone 765-418-5102
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