# TIMOTHY W TOLLESTRUP PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Neuropax Clinic of Nevada
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164654414
- **Authorized official:** TIMOTHY W TOLLESTRUP M.D. (PRESIDENT)
- **Authorized official phone:** (702) 666-0463

## Contact information

- **Practice address:** 3035 W HORIZON RIDGE PKWY STE 120, HENDERSON, NV 89052-4189
- **Practice address phone:** (702) 666-0463
- **Practice address fax:** (702) 666-0463
- **Mailing address:** 3035 W HORIZON RIDGE PKWY STE 120, HENDERSON, NV 89052-4189
- **Mailing address phone:** (702) 666-0463
- **Mailing address fax:** (702) 666-0463

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | NULL | Yes |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/20/2009
- **Last updated:** 03/11/2010