Provider First Line Business Practice Location Address:
6410 MEDICAL CENTER ST STE A100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-796-8500
Provider Business Practice Location Address Fax Number:
702-796-8502
Provider Enumeration Date:
05/28/2006