Provider First Line Business Practice Location Address:
50 E HASKELL ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINNEMUCCA
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89445-3576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-304-8748
Provider Business Practice Location Address Fax Number:
775-625-8580
Provider Enumeration Date:
02/27/2006