Provider First Line Business Practice Location Address:
3601 S BUSINESS HIGHWAY 281
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-0287
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-271-0131
Provider Business Practice Location Address Fax Number:
888-815-0809
Provider Enumeration Date:
11/16/2005