Organization
1849 LLC
Active
Other names
Jonanthan R. Sorelle M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN RICHARD SORELLE M.D. (MANAGER)
(702) 568-0007
Entity
Organization
Contact information
Practice address
11 W PACIFIC AVE, HENDERSON, NV 89015-7304
(702) 568-0007
(702) 568-6299
Mailing address
PO BOX 33292, LAS VEGAS, NV 89133-3292
(702) 568-0007
(702) 568-6299
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
12562
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12562
MEDIAL LICENSE
NV
Enumeration date
03/03/2010
Last updated
03/03/2010
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