Provider First Line Business Practice Location Address:
20 OLIVARRIA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCDERMITT
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-532-8530
Provider Business Practice Location Address Fax Number:
775-532-8531
Provider Enumeration Date:
11/23/2010