Provider First Line Business Practice Location Address:
4417 OASIS PLAINS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89085-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-688-1470
Provider Business Practice Location Address Fax Number:
702-688-1470
Provider Enumeration Date:
04/25/2012