Provider First Line Business Practice Location Address:
333 NORTH SANTA ROSA
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF SAN ANTONIO
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-704-4807
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2007