Provider First Line Business Practice Location Address:
2517 E LAKE MEAD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89030-6410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-642-7711
Provider Business Practice Location Address Fax Number:
702-642-8822
Provider Enumeration Date:
03/17/2008