Provider First Line Business Practice Location Address:
8000 US HIGHWAY 287
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHILDRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79201-7146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-937-8844
Provider Business Practice Location Address Fax Number:
940-937-8855
Provider Enumeration Date:
03/24/2006