Individual provider · NPI-1
Luis Herrera
Radiologic Technologist, Radiation Therapy · Kingman, AZ
NPI number1639095144
StatusActive
Last updated in NPPESJun 29, 2026
Details
- NPI
- 1639095144
- Entity type
- Individual (NPI-1)
- Name
- Luis Herrera
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 29, 2026
- Certification date
- Jun 28, 2026
- Last updated
- Jun 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2471R0002X | Radiologic Technologist, Radiation Therapy | CTT0000104046 | AZ | Yes |
Practice location
3939 N Stockton Hill Rd Ste AKingman, AZ 86409-3247
Phone 954-439-6167
Mailing address
777 Harrah Way Apt 107Lake Havasu City, AZ 86403-0813
Phone 954-439-6167
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