Provider First Line Business Practice Location Address:
5224 75TH ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79424-2523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-797-4000
Provider Business Practice Location Address Fax Number:
806-771-3659
Provider Enumeration Date:
08/09/2006