CHUKAR HAVEN ANESTHESIA PC
Nursing at Sunset Dr, Riverton, WY

License number
Wyoming 22560.0355
Category
Nursing
Type
Nurse Anesthetist, Certified Registered
Owner
Name: MATTHEW ALLFORD MULLINIX CRNA
Title: PRESIDENT
Phone: (307) 856-4161
Address
Address
2100 W Sunset Dr, Riverton, WY 82501
National Provider ID: 1619274347
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Chukar Haven Anesthesia, PC

Riverton, WY  -  White Salmon, WA

Registration:
Feb 15, 2007
Addresses:
589 Downs Cir, Riverton, WY 82501 (Physical)
1175 NW Baker Dr, White Salmon, WA 98672 (Mailing)
State ID:
2007-000532155
Business type:
Profit Corporation - Domestic
Expiration:
Perpetual

Chukar Haven Anesthesia, PC

614 Pr Rd, Riverton, WY 82501

Industry:
Medical Doctor's Office
President:
Matthew A. Mullinix (President)

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