Provider First Line Business Practice Location Address:
403 S WW WHITE ROAD, SUITE 222B
Provider Second Line Business Practice Location Address:
JUSTICE WORKS TX
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78219-5741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-538-5839
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2006