Provider First Line Business Practice Location Address:
836 NORTH 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UVALDE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-278-4444
Provider Business Practice Location Address Fax Number:
830-278-6300
Provider Enumeration Date:
12/26/2006