Provider First Line Business Practice Location Address:
CONCORD MEDICAL GROUP
Provider Second Line Business Practice Location Address:
1602 AVENUE Q
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-829-6613
Provider Business Practice Location Address Fax Number:
800-611-5029
Provider Enumeration Date:
10/18/2006