Provider First Line Business Practice Location Address:
TTUHSC 3601 4TH STREET MS 9410, OFFICE 4B076
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79430-4412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-743-2040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/06/2020