Provider First Line Business Practice Location Address:
10251 PRICKLY PEAR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79119-0092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-358-2987
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2026