Organization
MCLV2020 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MAXHAM DO (OWNER)
(801) 660-0676
Entity
Organization
Contact information
Practice address
1597 E WINDMILL LN, LAS VEGAS, NV 89123-1920
(702) 361-0125
Mailing address
2156 FOUNTAIN SPRINGS DR, HENDERSON, NV 89074-1576
(801) 660-0676
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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