Provider First Line Business Practice Location Address:
5586 S FORT APACHE RD
Provider Second Line Business Practice Location Address:
#100 SOUTHERN NEVADA NEONATAL SERVICES INC
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89148-3619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-384-8099
Provider Business Practice Location Address Fax Number:
702-384-3930
Provider Enumeration Date:
12/28/2005