Provider First Line Business Practice Location Address:
2500 PERLITER 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:
89030-7309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-396-4165
Provider Business Practice Location Address Fax Number:
702-656-0026
Provider Enumeration Date:
06/27/2005