Provider First Line Business Practice Location Address:
2072 IDAHO 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:
89801-2627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-254-8618
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2026