Provider First Line Business Mailing Address:
99 MDSS/SGSR 4700 N LAS VEGAS BLVD NORTH
Provider Second Line Business Mailing Address:
ATTN: THIRD PARTY BILLING
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-653-3589
Provider Business Mailing Address Fax Number: