Provider First Line Business Practice Location Address:
ESD ATHLETICS
Provider Second Line Business Practice Location Address:
4100 MERRELL ROAD
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75229-6200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-353-5889
Provider Business Practice Location Address Fax Number:
214-353-5825
Provider Enumeration Date:
03/07/2007