Organization
CHUKAR HAVEN ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ALLFORD MULLINIX CRNA (PRESIDENT)
(307) 856-4161
Entity
Organization
Contact information
Practice address
2100 W SUNSET DR, ANESTHESIA - MULLINIX, RIVERTON, WY 82501-2274
(307) 856-4161
Mailing address
2100 W SUNSET DR, ANESTHESIA - MULLINIX, RIVERTON, WY 82501-2274
(307) 856-4161
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22560.0355
WY
Other
Enumeration date
02/15/2011
Last updated
06/02/2011
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