Provider First Line Business Practice Location Address:
1800 GARNER FIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UVALDE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78801-6210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-278-4453
Provider Business Practice Location Address Fax Number:
830-278-3427
Provider Enumeration Date:
06/08/2005