Provider First Line Business Practice Location Address:
701 S MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-693-6671
Provider Business Practice Location Address Fax Number:
903-693-6687
Provider Enumeration Date:
10/06/2005