Provider First Line Business Practice Location Address:
1616 S CAROLINA ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-8316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-792-4843
Provider Business Practice Location Address Fax Number:
956-423-0439
Provider Enumeration Date:
12/01/2009