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General NPI Number Information
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NPI Number | 1609043801
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Entity Type | Organization
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Legal Business Name | STEVEN OLENCHAK, PC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 10/29/2011
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Provider Practice Location Address
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Address Line | 1399 GALLERIA DR 203
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City | HENDERSON
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State | NV
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Zip | 89014-6662
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Country | US
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Telephone | 702-951-7238
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Fax | 702-413-7240
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Provider Business Mailing Address
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Address Line | 1399 GALLERIA DR 203
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City | HENDERSON
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State | NV
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Zip | 89014-6662
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Country | US
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Telephone | 702-951-7238
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Fax | 702-413-7240
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN L OLENCHAK
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Credential | PAC
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Telephone | 702-951-7238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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