Provider First Line Business Practice Location Address:
32 N INWOOD HEIGHTS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78248-2315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-837-9140
Provider Business Practice Location Address Fax Number:
210-239-6937
Provider Enumeration Date:
10/02/2006