Provider First Line Business Practice Location Address:
135 W 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINNEMUCCA
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89445-3406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-625-2222
Provider Business Practice Location Address Fax Number:
775-625-1131
Provider Enumeration Date:
06/17/2025