Provider First Line Business Practice Location Address:
6501 UNIVERSITY AVE
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:
79413-5849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-788-0101
Provider Business Practice Location Address Fax Number:
806-797-0335
Provider Enumeration Date:
10/02/2013