Provider First Line Business Practice Location Address:
3601 4TH STREET MS 8340
Provider Second Line Business Practice Location Address:
DEPT OB/GYN
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-476-2080
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2010