Provider First Line Business Practice Location Address:
1184 COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89801-3424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-777-3937
Provider Business Practice Location Address Fax Number:
775-777-3334
Provider Enumeration Date:
11/20/2006