Provider First Line Business Practice Location Address:
115 E TEXAS BLVD
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:
79022-4319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-244-0015
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2009