Provider First Line Business Practice Location Address:
234 SAN PEDRO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78205-1103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-224-2424
Provider Business Practice Location Address Fax Number:
210-224-2040
Provider Enumeration Date:
06/07/2006