Individual
MICHAEL ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
620 SHADOW LN, LAS VEGAS, NV 89106-4119
(702) 388-4500
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1104
NV
363AM0700X
Medical Physician Assistant
PA.0003633
CO
Other
Enumeration date
03/06/2008
Last updated
08/02/2024
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