Provider First Line Business Practice Location Address:
3349 S HWY 181
Provider Second Line Business Practice Location Address:
4
Provider Business Practice Location Address City Name:
KENEDY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78119-5268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-583-2579
Provider Business Practice Location Address Fax Number:
830-583-3560
Provider Enumeration Date:
11/17/2005