Organization
A THIRD HAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD LAVOR MOON CSFA (OWNER)
(702) 985-8297
Entity
Organization
Contact information
Practice address
9806 RED DEER ST, LAS VEGAS, NV 89143
(702) 985-8297
(702) 478-9114
Mailing address
9806 RED DEER ST, LAS VEGAS, NV 89143-1155
(702) 985-8297
(702) 478-9114
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
132674
NV
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132674
NBSTSA #
NV
Enumeration date
05/30/2014
Last updated
06/22/2018
Update your record
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