Provider First Line Business Practice Location Address:
3060 S. ALAMEDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-882-1211
Provider Business Practice Location Address Fax Number:
361-882-7644
Provider Enumeration Date:
10/18/2007