Organization
PHYSICIAN ASSISTANT SURGICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY JAMES VAN VLEET (PHYSICIAN ASSISTANT)
(702) 614-4178
Entity
Organization
Contact information
Practice address
8979 HAVILAND RD, LAS VEGAS, NV 89123-0617
(702) 614-4178
(702) 614-4179
Mailing address
8979 HAVILAND RD, LAS VEGAS, NV 89123-0617
(702) 614-4178
(702) 614-4179
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/16/2010
Last updated
01/16/2010
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