Provider First Line Business Practice Location Address:
1601 E HARRISON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7390
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-425-6344
Provider Business Practice Location Address Fax Number:
956-412-0501
Provider Enumeration Date:
01/15/2007