STATE OF NEVADA

SPARKS, NV
NPI1013243450
Entity TypeOrganization
Authorized ContactELIZABETH O'BRIEN
Business Manager
775-688-2030
Organization Subpart ?Yes
Primary Taxonomy207R00000X Internal Medicine
Enumeration Date2009-10-20
Last Update Date2009-10-20
Business Address
STATE OF NEVADA
480 GALLETTI WAY
SPARKS, NV 89431-5564
Phone number: 775-688-2001
Mailing Address
STATE OF NEVADA
480 GALLETTI WAY
SPARKS, NV 89431-5564
Phone number: 775-688-2001
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