Individual
KITRIN LANCE CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3015 HWY 95 STE 105, BULLHEAD CITY, AZ 86442-5142
(928) 763-2001
(928) 763-2038
Mailing address
3015 HWY 95 STE 105, BULLHEAD CITY, AZ 86442
(928) 763-2001
(928) 763-2038
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1830
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356297
—
AZ
Enumeration date
07/14/2005
Last updated
05/23/2024
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