Provider First Line Business Practice Location Address:
2809 S EXPRESSWAY 83 STE F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-664-9667
Provider Business Practice Location Address Fax Number:
956-664-2190
Provider Enumeration Date:
10/17/2005