Provider First Line Business Practice Location Address:
1623 HOSPITAL LOOP ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWYHEE
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-757-2403
Provider Business Practice Location Address Fax Number:
775-757-2041
Provider Enumeration Date:
02/25/2013