Individual
MR. IAN LARRY CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4785 S DURANGO DR, STE. 101, LAS VEGAS, NV 89147-8166
(702) 889-8444
Mailing address
1629 WINNERS CUP DR, LAS VEGAS, NV 89117-0819
(702) 557-1045
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1233
NV
Other
Enumeration date
07/02/2010
Last updated
10/08/2014
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