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Individual

SAMANTHA LUCERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1689 BRILL WAY, BULLHEAD CITY, AZ 86442-6541
(928) 219-7784
Mailing address
1689 BRILL WAY, BULLHEAD CITY, AZ 86442-6541

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
12/06/2024
Last updated
12/06/2024
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