Provider First Line Business Practice Location Address:
THE ATRUIM PROFESSIONAL BUILDING
Provider Second Line Business Practice Location Address:
14465 WEBB CHAPEL RD. SUITE 103
Provider Business Practice Location Address City Name:
FARMERS BRANCH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75234-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-241-8733
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2005