Provider First Line Business Practice Location Address:
2385 E PRATER WAY SUITE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPARKS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-359-7008
Provider Business Practice Location Address Fax Number:
775-356-7010
Provider Enumeration Date:
02/28/2007