Provider First Line Business Practice Location Address:
350 SHORT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GERLACH
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-557-2313
Provider Business Practice Location Address Fax Number:
775-557-2140
Provider Enumeration Date:
11/02/2006