Provider First Line Business Practice Location Address:
#3 MEDICAL DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-355-1313
Provider Business Practice Location Address Fax Number:
806-358-0335
Provider Enumeration Date:
09/20/2006