Provider First Line Business Practice Location Address:
3370 N. HWY 395 SOUTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARSON CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-267-5611
Provider Business Practice Location Address Fax Number:
775-267-9087
Provider Enumeration Date:
01/17/2007