Provider Demographics
NPI:1437780517
Name:LCANDERSON LLC
Entity type:Organization
Organization Name:LCANDERSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LETECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-250-1870
Mailing Address - Street 1:6630 S MCCARRAN BLVD STE A6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6136
Mailing Address - Country:US
Mailing Address - Phone:775-250-1870
Mailing Address - Fax:
Practice Address - Street 1:6630 S MCCARRAN BLVD STE A6
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6136
Practice Address - Country:US
Practice Address - Phone:775-250-1870
Practice Address - Fax:775-828-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy