| Name | CRAIG M. JORGENSON, M.D. |
|---|---|
| Address | 9975 S. EASTERN AVENUE, SUITE 110 |
| City | LAS VEGAS |
| State | NV |
| Zip | 89183-7950 |
| Mailing Address | 9975 S. EASTERN AVENUE, SUITE 110 |
| Mailing Address 2 | 9975 S. EASTERN AVENUE, SUITE 110 |
| Mailing City | LAS VEGAS |
| Mailing State | NV |
| Mailing Zip | 89183-7950 |
| Agent Type | Noncommercial Registered Agent |
| Company | NCC HOUSE CALLS, LLC |
|---|---|
| Entity Number | E0218852016-5 |
| NV Business ID | NV20161284063 |