Provider Demographics
NPI:1548500069
Name:ASDRUBAL I LOPEZ, DC, PS
Entity type:Organization
Organization Name:ASDRUBAL I LOPEZ, DC, PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-922-1909
Mailing Address - Street 1:902 S SULLIVAN RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9754
Mailing Address - Country:US
Mailing Address - Phone:509-922-1909
Mailing Address - Fax:509-922-6648
Practice Address - Street 1:902 S SULLIVAN RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-9754
Practice Address - Country:US
Practice Address - Phone:509-922-1909
Practice Address - Fax:509-922-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty