Provider First Line Business Practice Location Address:
1508 N ZARAGOZA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79936-8034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-747-7849
Provider Business Practice Location Address Fax Number:
724-348-8600
Provider Enumeration Date:
02/10/2026