Provider Demographics
NPI:1043052434
Name:LOPEZ, ABIGAIL (LMT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3646 POTTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-1700
Mailing Address - Country:US
Mailing Address - Phone:610-678-8600
Mailing Address - Fax:610-678-4747
Practice Address - Street 1:3646 POTTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-1700
Practice Address - Country:US
Practice Address - Phone:610-678-8600
Practice Address - Fax:610-678-4747
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG014405225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist