Provider First Line Business Practice Location Address:
620 SOUTH 12TH STREET
Provider Second Line Business Practice Location Address:
STE. 110
Provider Business Practice Location Address City Name:
ELKO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-738-0818
Provider Business Practice Location Address Fax Number:
775-738-0814
Provider Enumeration Date:
12/18/2007