Provider First Line Business Practice Location Address:
5550 N LAMB BLVD STE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89115-2004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-727-4899
Provider Business Practice Location Address Fax Number:
702-983-2192
Provider Enumeration Date:
11/04/2025