Provider First Line Business Practice Location Address:
209 COUNTRY CLUB DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KARNES CITY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78118-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-780-2426
Provider Business Practice Location Address Fax Number:
830-780-4248
Provider Enumeration Date:
08/17/2015