Provider First Line Business Practice Location Address:
4 MEDICAL DR STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMARILLO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79106-4166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-358-7300
Provider Business Practice Location Address Fax Number:
806-358-7301
Provider Enumeration Date:
02/28/2011