Provider Demographics
NPI:1356744262
Name:MOREHOUSE, LUCIUS QUINN (PT, DPT, MA)
Entity type:Individual
Prefix:DR
First Name:LUCIUS
Middle Name:QUINN
Last Name:MOREHOUSE
Suffix:
Gender:M
Credentials:PT, DPT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 S VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1855
Mailing Address - Country:US
Mailing Address - Phone:702-877-8898
Mailing Address - Fax:
Practice Address - Street 1:1250 S VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1855
Practice Address - Country:US
Practice Address - Phone:702-877-8898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2015-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist