Provider First Line Business Practice Location Address:
805 US HIGHWAY 83 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHILDRESS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79201-2318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-937-9030
Provider Business Practice Location Address Fax Number:
940-937-9010
Provider Enumeration Date:
07/05/2016