Individual
MARIO LANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
18700 N 64TH DR STE 301, GLENDALE, AZ 85308-7114
(623) 748-0145
Mailing address
2910 E DES MOINES ST, MESA, AZ 85213-6914
(480) 822-0107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
9455
AZ
Other
Enumeration date
10/24/2021
Last updated
03/14/2025
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