Provider First Line Business Practice Location Address:
11640 US HIGHWAY 87 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLSBAD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76934-7000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-465-4391
Provider Business Practice Location Address Fax Number:
325-465-2878
Provider Enumeration Date:
10/02/2006