Provider First Line Business Practice Location Address:
1800 S HUGHES ST
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:
79102-2651
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-356-6002
Provider Business Practice Location Address Fax Number:
806-373-9666
Provider Enumeration Date:
11/07/2006