Individual
KEVIN DERRICK LUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10401 W CHARLESTON BLVD, LAS VEGAS, NV 89135-1151
(702) 207-4242
Mailing address
10401 W CHARLESTON BLVD, LAS VEGAS, NV 89135-1151
(702) 207-4242
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A0823
NV
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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