Provider First Line Business Practice Location Address:
530 MELARKEY ST
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
WINNEMUCCA
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89445-3178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-304-4849
Provider Business Practice Location Address Fax Number:
775-623-3282
Provider Enumeration Date:
12/12/2006