Individual
LANCE GU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
613 IVY SPRING ST, LAS VEGAS, NV 89138-6070
(702) 328-3937
Mailing address
613 IVY SPRING ST, LAS VEGAS, NV 89138-6070
(702) 328-3937
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13-1198
NV
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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