Provider First Line Business Practice Location Address:
1470 MEDICAL PARKWAY
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
CARSON CITY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-883-3636
Provider Business Practice Location Address Fax Number:
775-882-2382
Provider Enumeration Date:
03/18/2009