Provider First Line Business Practice Location Address:
1008 MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALICE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78332-4212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-668-4278
Provider Business Practice Location Address Fax Number:
361-668-6309
Provider Enumeration Date:
07/09/2013