Individual
RONALD LAVOR MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST/CSFA
Contact information
Practice address
9806 RED DEER ST, LAS VEGAS, NV 89143
(702) 985-8297
Mailing address
9806 RED DEER ST, LAS VEGAS, NV 89143-1155
(702) 985-8297
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
04/23/2012
Last updated
06/22/2018
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