Organization
JR SORELLE ARIZONA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN R SORELLE MD (OWNER)
(702) 739-4263
Entity
Organization
Contact information
Practice address
5300 S HIGHWAY 95, SUITE M, FORT MOHAVE, AZ 86426-9251
(702) 739-4263
(877) 739-3590
Mailing address
9080 W POST RD, SUITE 101, LAS VEGAS, NV 89148-2419
(702) 739-4263
(877) 739-3590
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
41010
AZ
Other
Enumeration date
06/21/2013
Last updated
06/21/2014
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