| Name | SETH FULLER |
|---|---|
| Address | 567 ALDEN LANE |
| City | INCLINE VILLAGE |
| State | NV |
| Zip | 89450 |
| Mailing Address | P.O. BOX 4801 |
| Mailing Address 2 | P.O. BOX 4801 |
| Mailing City | INCLINE VILLAGE |
| Mailing State | NV |
| Mailing Zip | 89450 |
| Agent Type | Noncommercial Registered Agent |
| Company | WASHOE MODERN MEDICINE GROUP LLC |
|---|---|
| Entity Number | E0105232014-3 |
| NV Business ID | NV20141141211 |