Provider First Line Business Practice Location Address:
227 W KLEBERG AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78363-4427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-592-6451
Provider Business Practice Location Address Fax Number:
361-595-4545
Provider Enumeration Date:
01/17/2006