Provider First Line Business Practice Location Address:
2829 WEST NW HWY
Provider Second Line Business Practice Location Address:
STE 904 NORTHWEST MEDICAL AND REHAB
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-350-0504
Provider Business Practice Location Address Fax Number:
214-350-0944
Provider Enumeration Date:
05/25/2007