Provider First Line Business Practice Location Address:
300 3RD ST SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHILDRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79201-5414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-663-6321
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/07/2026