Provider First Line Business Practice Location Address:
2425 N LAMB BLVD STE 120
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:
89115-5420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-851-7766
Provider Business Practice Location Address Fax Number:
702-851-7760
Provider Enumeration Date:
01/21/2008