Provider Demographics
NPI:1871822429
Name:AH CHIN, RAY CHUN KONG (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:CHUN KONG
Last Name:AH CHIN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 GAVILAN LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-3368
Mailing Address - Country:US
Mailing Address - Phone:808-264-3662
Mailing Address - Fax:
Practice Address - Street 1:3180 GAVILAN LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-3368
Practice Address - Country:US
Practice Address - Phone:808-264-3662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT. 3673225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist