Individual
MR. STAR RAY CHENOWETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
973 MICA DR, 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
363AM0700X
Medical Physician Assistant
PA1183
NV
363AS0400X
Surgical Physician Assistant
Primary
PA1183
NV
Other
Enumeration date
10/21/2009
Last updated
10/04/2010
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