Provider First Line Business Practice Location Address:
110 UPTOWN AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78520-7563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-525-7817
Provider Business Practice Location Address Fax Number:
956-525-7800
Provider Enumeration Date:
07/03/2008