Provider First Line Business Practice Location Address:
10 MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LUFKIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75904-3173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-633-0630
Provider Business Practice Location Address Fax Number:
877-916-5022
Provider Enumeration Date:
10/16/2009