Provider First Line Business Practice Location Address:
UNLV PRACTICE CLINIC
Provider Second Line Business Practice Location Address:
CEB 226, 4505 S. MARYLAND PARKWAY
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-895-1532
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/05/2015