Provider First Line Business Practice Location Address:
822 E. HARRISON ST.
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:
78550-7120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-428-4398
Provider Business Practice Location Address Fax Number:
956-428-1868
Provider Enumeration Date:
02/07/2012