Provider First Line Business Practice Location Address:
2113 N HIGHWAY 175
Provider Second Line Business Practice Location Address:
FCI SEAGOVILLE, HEALTH SERVICES
Provider Business Practice Location Address City Name:
SEAGOVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75159-2237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-287-4095
Provider Business Practice Location Address Fax Number:
972-287-6769
Provider Enumeration Date:
01/14/2007