Provider First Line Business Practice Location Address:
224 E 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUMAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79029-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-934-7171
Provider Business Practice Location Address Fax Number:
806-934-3343
Provider Enumeration Date:
04/16/2012