Provider First Line Business Practice Location Address:
1820 E WARM SPRINGS RD.,
Provider Second Line Business Practice Location Address:
SUITE 145
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-233-5217
Provider Business Practice Location Address Fax Number:
702-989-0286
Provider Enumeration Date:
12/14/2006