Provider First Line Business Practice Location Address:
116 N FIFTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UVALDE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78801-5415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-278-2549
Provider Business Practice Location Address Fax Number:
830-278-2848
Provider Enumeration Date:
11/01/2006