Provider First Line Business Practice Location Address:
513 W BRIDGE ST
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
YERINGTON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89447-2661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-463-4500
Provider Business Practice Location Address Fax Number:
775-463-4545
Provider Enumeration Date:
01/22/2009