Individual
MR. CARLO PACADA DESLATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4980 W SAHARA AVE STE 260, LAS VEGAS, NV 89146-3435
(702) 820-5070
Mailing address
1186 RED MARGIN CT UNIT 103, LAS VEGAS, NV 89183-4975
(510) 284-7074
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506321
NV
Other
Enumeration date
12/14/2019
Last updated
12/14/2019
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