Provider First Line Business Practice Location Address:
3601 4TH ST
Provider Second Line Business Practice Location Address:
DEPARTMENT OF SURGERY - TTUHSC
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79430-1786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
67-437-8748
Provider Business Practice Location Address Fax Number:
806-743-1225
Provider Enumeration Date:
02/03/2007