Individual
LUIS LARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
9141 ALAKING CT, CAPITOL HEIGHTS, MD 20743-5043
(301) 499-4655
(301) 499-0902
Mailing address
1160 1ST ST NE APT 346, WASHINGTON, DC 20002-4793
(702) 716-9701
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211115
VA
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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