Provider First Line Business Practice Location Address:
601 S HWY 160
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-727-2404
Provider Business Practice Location Address Fax Number:
775-727-2410
Provider Enumeration Date:
04/17/2007