Individual
ZOSIMO LUGO SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 E BONANZA RD, LAS VEGAS, NV 89101-3038
(702) 947-4449
Mailing address
525 E BONANZA RD, LAS VEGAS, NV 89101-3038
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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