Provider First Line Business Practice Location Address:
235 E MITCHELL ST
Provider Second Line Business Practice Location Address:
REIMBURSEMENT OFFICE
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78210-3844
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-531-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2008