Provider First Line Business Practice Location Address:
6224 NARROW ISTHMUS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89139-6410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-883-7336
Provider Business Practice Location Address Fax Number:
702-333-2197
Provider Enumeration Date:
06/19/2025