Provider First Line Business Practice Location Address:
6850 N DURANGO DR STE 211
Provider Second Line Business Practice Location Address:
MOUTAINSIDE INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89149-4597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-202-2233
Provider Business Practice Location Address Fax Number:
702-685-6738
Provider Enumeration Date:
02/07/2006