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General NPI Number Information
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NPI Number | 1750824371
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Entity Type | Organization
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Legal Business Name | LASHER SPORT
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 5720 ARVILLE ST STE 105
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City | LAS VEGAS
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State | NV
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Zip | 89118-3036
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Country | US
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Telephone | 907-529-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 5720 ARVILLE ST STE 105
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City | LAS VEGAS
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State | NV
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Zip | 89118-3036
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Country | US
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Telephone | 907-529-8833
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. WILLIAM LASHER
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Credential |
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Telephone | 907-229-5274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2000248-031-170
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License Number State | NV
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