Provider Demographics
NPI:1043096472
Name:LACEDA, JOHN (DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:LACEDA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:3333 STRAWBERRY ROAN RD
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2477
Mailing Address - Country:US
Mailing Address - Phone:702-630-1354
Mailing Address - Fax:
Practice Address - Street 1:7121 W CRAIG RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6023
Practice Address - Country:US
Practice Address - Phone:725-726-7847
Practice Address - Fax:725-726-7876
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist