JAY RUSSELL WAITE

FALLON, NV
NPI1114064789
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-01-31
Last Update Date2007-07-08
Business Address
Mr. JAY RUSSELL WAITE IDC
4755 PASTURE RD
FALLON, NV 89496-5000
Phone number: 775-426-3130
Mailing Address
Mr. JAY RUSSELL WAITE IDC
733 ORCHARD DR APT A
FALLON, NV 89406-6158
Phone number: 775-426-3130