Provider First Line Business Practice Location Address:
6070 S. FORT APACHE RD.
Provider Second Line Business Practice Location Address:
SUITE #200
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-730-2001
Provider Business Practice Location Address Fax Number:
702-730-2005
Provider Enumeration Date:
08/18/2005