Provider First Line Business Practice Location Address:
7400 MERTON MINTER BLVD
Provider Second Line Business Practice Location Address:
AUDIC L MURPHY 116B US DEPT OF VETERANS AFFAIRS VA HOSP
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-699-2147
Provider Business Practice Location Address Fax Number:
210-949-3301
Provider Enumeration Date:
09/07/2006