Provider First Line Business Practice Location Address:
7400 MERTON MINTER ST # 1A
Provider Second Line Business Practice Location Address:
AUDIE MURPHY VETERANS HOSPITAL
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-949-9248
Provider Business Practice Location Address Fax Number:
210-949-3107
Provider Enumeration Date:
03/06/2007