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NPI Code Detail

MEDICARE: DR. JOHN LACEDA DPT

MEDICARE:  DR. JOHN  LACEDA  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1043096472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN LACEDA DPT
Provider Business Mailing Address
First Line : 3333 STRAWBERRY ROAN RD
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89032-2477
Country : US
Telephone Number : 702-630-1354
Fax Number :
Provider Business Practice Location Address
First Line : 7121 W CRAIG RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-6023
Country : US
Telephone Number : 725-726-7847
Fax Number : 725-726-7876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2023
Last Update Date : 08/22/2024

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Directions to “ DR. JOHN LACEDA DPT” Practice Location

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