Provider First Line Business Practice Location Address:
657 N TOWN CENTER DR
Provider Second Line Business Practice Location Address:
SUMMERLIN HOSPITAL - 5TH FLOOR PICU
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89144-6367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-233-7435
Provider Business Practice Location Address Fax Number:
702-853-8505
Provider Enumeration Date:
05/04/2006