Provider First Line Business Practice Location Address:
1141 S HIGHWAY 160 STE 8
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAHRUMP
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89048-4713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-727-7100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2006