Provider First Line Business Practice Location Address:
10146 HUEBNER RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78240-3412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-0110
Provider Business Practice Location Address Fax Number:
210-614-0007
Provider Enumeration Date:
02/28/2006