Provider First Line Business Practice Location Address:
1360 E NEVADA HWY 372
Provider Second Line Business Practice Location Address:
UNIT #2
Provider Business Practice Location Address City Name:
PAHRUMP
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-818-2444
Provider Business Practice Location Address Fax Number:
702-818-2440
Provider Enumeration Date:
09/04/2019