Provider First Line Business Practice Location Address:
1610 E HARRISON AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-756-2553
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2011