Provider First Line Business Practice Location Address:
770 S. 12TH ST
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:
89801-4054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-738-1770
Provider Business Practice Location Address Fax Number:
775-738-5341
Provider Enumeration Date:
08/12/2006