IndividualActive
Allen Park, PA-C
NPI 1548714181 · Physician Assistant · Las Vegas, NV
Provider details
- NPI number
- 1548714181
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone: (815) 325-1699
Approximate (ZIP-level) locationGet directions
Mailing address
236 W Daisy Cir
Romeoville, IL 60446-4972
Registry dates
- Enumerated
- 2016-08-11
- Last updated
- 2016-08-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.