| Name | FAUZIA CARULLO, MD |
|---|---|
| Address | 2901 N TENAYA WAY STE 200 |
| City | LAS VEGAS |
| State | NV |
| Zip | 89128 |
| Mailing Address | 2901 N TENAYA WAY STE 200 |
| Mailing Address 2 | 2901 N TENAYA WAY STE 200 |
| Mailing City | LAS VEGAS |
| Mailing State | NV |
| Mailing Zip | 89128 |
| Agent Type | Noncommercial Registered Agent |
| Company | M SPA INC |
|---|---|
| Entity Number | E0424292014-5 |
| NV Business ID | NV20141526430 |