Provider First Line Business Practice Location Address:
1100 WILFORD HALL LOOP
Provider Second Line Business Practice Location Address:
WHASC, MH CLINIC
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-809-9964
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2023