Provider First Line Business Practice Location Address:
400 ROSALIND REDFERN GROVER PKWY, STE 281
Provider Second Line Business Practice Location Address:
CRADDICK MEDICAL OFFICE BUILDING
Provider Business Practice Location Address City Name:
MIDLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79701-5904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-688-8888
Provider Business Practice Location Address Fax Number:
432-686-8348
Provider Enumeration Date:
02/11/2010