Provider First Line Business Practice Location Address:
5816 EAST DRIVE UNIT A
Provider Second Line Business Practice Location Address:
BRONZESTAR AMBULANCE SERVICE LLC
Provider Business Practice Location Address City Name:
LAREDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78041-6851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-712-3667
Provider Business Practice Location Address Fax Number:
956-753-6013
Provider Enumeration Date:
05/26/2010