Provider First Line Business Practice Location Address:
700 W UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
LIFE SERVICES AND WELLNESS
Provider Business Practice Location Address City Name:
KINGSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78363-8202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-593-2904
Provider Business Practice Location Address Fax Number:
361-593-2903
Provider Enumeration Date:
03/12/2007