Provider First Line Business Practice Location Address:
RR 1 BOX 17
Provider Second Line Business Practice Location Address:
907 E. HILL ST
Provider Business Practice Location Address City Name:
SPUR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79370-9302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-271-3306
Provider Business Practice Location Address Fax Number:
806-271-4256
Provider Enumeration Date:
12/13/2007