Lucas R Derting, PA-C

NPI #1306846381 in Pueblo, Colorado

Provider Information

NPI Number
1306846381
Entity Type
Individual
Name
Lucas R Derting, PA-C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
PA-C
Enumeration Date
Jul 29, 2005
Last Updated
Nov 3, 2016

Practice Location

Address
1600 NORTH GRAND AVENUE
Address 2
SUITE 500
City
Pueblo
ZIP Code
81003-2757
Phone
(719) 545-0663

Specialties & Taxonomy Codes

Specialty
Physician Assistant
Physician Assistant - SurgicalSurgical

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