| Name | DIANA PRUITT |
|---|---|
| Address | 777 LASSEN DRIVE |
| City | GARDNERVILLE |
| State | NV |
| Zip | 89460 |
| Mailing Address | C/O TWC 1067 4TH ST |
| Mailing Address 2 | C/O TWC 1067 4TH ST |
| Mailing City | S LAKE TAHOE |
| Mailing State | CA |
| Mailing Zip | 96150 |
| Agent Type | Noncommercial Registered Agent |
| Company | MOUNTAIN MEADOWS MEDICAL GROUP OF CALIFORNIA, INC. |
|---|---|
| Entity Number | C4459-1999 |
| NV Business ID | NV19991177788 |