Provider First Line Business Practice Location Address:
1971 PAHRUMP VALLEY BLVD
Provider Second Line Business Practice Location Address:
UNIT D
Provider Business Practice Location Address City Name:
PAHRUMP
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-751-4999
Provider Business Practice Location Address Fax Number:
775-751-4997
Provider Enumeration Date:
03/15/2008