Male or Other

Lance Gu COTA/L

Occupational Therapy Assistant in Las Vegas, NV(View on Map)

Full Name

Lance Gu COTA/L

NPI Number

1326827080

NPI Type

Individual Provider

Gender

Male

Enumeration Date

09/22/2023

Specialties

(Taxonomies)

Code

224Z00000X

Primary Taxonomy

Yes

Licenses

State

Nevada

License Number

13-1198

Contact
Information

Purpose

Mailing
Location

Address

613 IVY SPRING ST
613 IVY SPRING ST

City

Las Vegas
Las Vegas

State

NV
NV

Postal Code

89138-6070
89138-6070

Country

US
US

Telephone Number

(702) 328-3937
(702) 328-3937

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/22/2023

Provider Address

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