Provider First Line Business Practice Location Address:
226 N GETTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UVALDE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78801-5204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-591-2210
Provider Business Practice Location Address Fax Number:
830-591-9150
Provider Enumeration Date:
11/07/2006