Provider First Line Business Practice Location Address:
19 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ABILENE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79606-5269
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-690-0620
Provider Business Practice Location Address Fax Number:
325-690-0622
Provider Enumeration Date:
09/20/2006