| Name | WES GRANSTROM, CHEIF EXECUTIVE OFFICER |
|---|---|
| Address | 82 E GLENDALE AVE |
| City | SPARKS |
| State | NV |
| Zip | 89431 |
| Mailing State | NV |
| Agent Type | Noncommercial Registered Agent |
| Company | TERRANCE BALLARD, M.D., P.C. |
|---|---|
| Entity Number | E0466872005-4 |
| NV Business ID | NV20051519945 |