Provider First Line Business Practice Location Address:
1204 N MOUND
Provider Second Line Business Practice Location Address:
NACOGDOCHES MEMORIAL HOSPITAL LAB
Provider Business Practice Location Address City Name:
NACOGDOCHES
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-462-3635
Provider Business Practice Location Address Fax Number:
936-569-4615
Provider Enumeration Date:
12/15/2005