Provider First Line Business Practice Location Address:
2505 MOUNTAIN CITY HWY
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:
89801-4496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-738-2779
Provider Business Practice Location Address Fax Number:
775-738-8624
Provider Enumeration Date:
10/11/2017