Provider First Line Business Practice Location Address:
5024 BROADWAY ST
Provider Second Line Business Practice Location Address:
HUNTLEIGH AT HOME
Provider Business Practice Location Address City Name:
ALAMO HEIGHTS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78209-5708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-826-6969
Provider Business Practice Location Address Fax Number:
210-826-6967
Provider Enumeration Date:
02/08/2007