Individual
MRS. LARISSA IVANOVNA RUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9701 WEST FLAMINGO RD, #4, LAS VEGAS, NV 89147
(702) 240-3929
(702) 240-4203
Mailing address
9701 WEST FLAMINGO RD, #4, LAS VEGAS, NV 89147
(702) 240-3929
(702) 240-4203
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PA1268
NV
363A00000X
Physician Assistant
Primary
PA1268
NV
Other
Enumeration date
03/17/2011
Last updated
10/10/2024
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