Provider First Line Business Practice Location Address:
50 E HASKELL ST STE C
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:
775-623-4050
Provider Business Practice Location Address Fax Number:
775-623-0730
Provider Enumeration Date:
04/30/2008