Provider First Line Business Practice Location Address:
1389 LAMOILLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89801-4317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-753-8670
Provider Business Practice Location Address Fax Number:
775-753-2460
Provider Enumeration Date:
02/19/2007