Provider First Line Business Practice Location Address:
HWY 95 AND ARMORY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAWTHORNE
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-945-3045
Provider Business Practice Location Address Fax Number:
775-945-1829
Provider Enumeration Date:
07/19/2006