Provider First Line Business Practice Location Address:
1300 E HARRISON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-428-7482
Provider Business Practice Location Address Fax Number:
956-428-7544
Provider Enumeration Date:
05/27/2008