Most Relevant Information
Provider Data
| NPI Number: | 1003512245 |
| Provider Name: | BROCK LAMONT VANCE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | PA2775 |
Most Important Dates
| Enumeration Date: | 01/31/2023 |
| Last Updated: | 01/31/2023 |
Provider Practice Location
925 WELLS AVENUE
WEST WENDOVER
NV
89883
Practice Location Phone/Fax
| Phone: | 7756642220 |
| Fax: |
Provider Mailing Location
PO BOX 2734
WEST WENDOVER
NV
898832734
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |