Provider First Line Business Practice Location Address:
219 E TEXAS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALHART
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79022-4321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-249-5538
Provider Business Practice Location Address Fax Number:
806-249-5530
Provider Enumeration Date:
10/08/2008