LUCAS PORTER

LAS VEGAS, NV
NPI1225541808
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NV  PA2514)
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID  At-569)
363A00000X Physician Assistant
Enumeration Date2017-11-06
Last Update Date2021-12-03
Business Address
LUCAS PORTER PA-C
2680 CRIMSON CANYON DR
LAS VEGAS, NV 89128-0841
Phone number: 208-814-5075
Mailing Address
LUCAS PORTER PA-C
2020 PALOMINO LN STE 110
LAS VEGAS, NV 89106-4892
Phone number: 702-474-7200