Provider Demographics
NPI:1609043801
Name:STEVEN OLENCHAK, PC
Entity Type:Organization
Organization Name:STEVEN OLENCHAK, PC
Other - Org Name:PAIN CENTER OF HENDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:OLENCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:PAC
Authorized Official - Phone:702-951-7238
Mailing Address - Street 1:1399 GALLERIA DR
Mailing Address - Street 2:203
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6662
Mailing Address - Country:US
Mailing Address - Phone:702-951-7238
Mailing Address - Fax:702-413-7240
Practice Address - Street 1:1399 GALLERIA DR
Practice Address - Street 2:203
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6662
Practice Address - Country:US
Practice Address - Phone:702-951-7238
Practice Address - Fax:702-413-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2011-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty