Organization
THEODORE POTRUCH MD LTD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE POTRUCH MD (PRESIDENT)
(702) 000-0000
Entity
Organization
Contact information
Practice address
2020 GOLDRING AVE, PRACTICE CLOSED, LAS VEGAS, NV 89106-4000
(702) 000-0000
(702) 000-0000
Mailing address
2020 GOLDRING AVE, PRACTICE CLOSED, LAS VEGAS, NV 89106-4000
(702) 000-0000
(702) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2006
Last updated
03/06/2018
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