Provider First Line Business Practice Location Address:
401 N. TOM GREEN
Provider Second Line Business Practice Location Address:
PERMIAN BASIN KIDNEY CENTER
Provider Business Practice Location Address City Name:
ODESSA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-279-0905
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2009