| Name | MICHAEL P. HAMBSCH |
|---|---|
| Address | 4 MEADOW DRIVE |
| City | LAKE TAHOE |
| State | NV |
| Zip | 89449 |
| Mailing Address | P.O. BOX 5787 |
| Mailing Address 2 | P.O. BOX 5787 |
| Mailing City | LAKE TAHOE |
| Mailing State | NV |
| Mailing Zip | 89449 |
| Agent Type | Noncommercial Registered Agent |
| Company | LAKE TAHOE SPORTS MEDICINE FELLOWSHIP, INC. |
|---|---|
| Entity Number | E0574842006-3 |
| NV Business ID | NV20061191179 |