Provider First Line Business Practice Location Address:
215 N SAN SABA ST
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-227-3701
Provider Business Practice Location Address Fax Number:
210-227-8628
Provider Enumeration Date:
09/12/2006