Provider First Line Business Practice Location Address:
3880 SOUTH JONES BLVD STE #102
Provider Second Line Business Practice Location Address:
SPRING VALLEY FAMILY CARE
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-367-0323
Provider Business Practice Location Address Fax Number:
702-367-4431
Provider Enumeration Date:
10/16/2006