Provider First Line Business Practice Location Address:
3533 S ALAMEDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78411-1721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-694-4391
Provider Business Practice Location Address Fax Number:
361-694-4821
Provider Enumeration Date:
01/27/2010