Provider First Line Business Practice Location Address:
3301 E. FIFTH ST.
Provider Second Line Business Practice Location Address:
NEVADA STATE PRISON,
Provider Business Practice Location Address City Name:
CARSON CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-887-3439
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/24/2008