Provider First Line Business Practice Location Address:
300 SHEPHERD DR
Provider Second Line Business Practice Location Address:
SUITE B BACK NECK & SPORTS PAIN RELIEF CENTER
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-880-1040
Provider Business Practice Location Address Fax Number:
713-880-4451
Provider Enumeration Date:
07/17/2006