Individual
JEROMY DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
973 MICA DRIVE, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
(775) 783-6191
Mailing address
973 MICA DR, SUITE 201, CARSON CITY, NV 89705-7255
(775) 783-6190
(775) 783-6191
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0335
NV
363A00000X
Physician Assistant
PA15875
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA158750
—
CA
Enumeration date
08/31/2006
Last updated
07/21/2021
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