Provider First Line Business Practice Location Address:
1401 TENNESSEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALHART
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79022-5137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-244-7813
Provider Business Practice Location Address Fax Number:
806-244-7822
Provider Enumeration Date:
02/19/2007