Provider First Line Business Practice Location Address:
1722 SOUTH CAROLINA ST.
Provider Second Line Business Practice Location Address:
STE. B
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-425-1368
Provider Business Practice Location Address Fax Number:
956-425-1408
Provider Enumeration Date:
11/20/2024