Individual
DAVID WONNACOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3852 PALOS VERDES ST, SUITE 40, LAS VEGAS, NV 89119-6909
(702) 485-1300
Mailing address
3852 PALOS VERDES ST, SUITE 40, LAS VEGAS, NV 89119-6909
(702) 485-1300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251B00000X
—
NV
Enumeration date
06/24/2015
Last updated
06/24/2015
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