Provider First Line Business Practice Location Address:
3030 CANYON TRAIL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALHART
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79022-7621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-282-8999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/30/2013