Provider First Line Business Practice Location Address:
3610 S NEVADA HIGHWAY 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAHRUMP
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89048-4805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-253-6598
Provider Business Practice Location Address Fax Number:
801-931-2263
Provider Enumeration Date:
04/07/2025