Provider First Line Business Practice Location Address:
7455 W WASHINGTON AVE STE 160
Provider Second Line Business Practice Location Address:
LONGFORD MEDICAL CENTER
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89128-4337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-252-8255
Provider Business Practice Location Address Fax Number:
702-380-8255
Provider Enumeration Date:
11/07/2008