Provider First Line Business Practice Location Address:
1601 TENNESSEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALHART
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79022-5110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-249-4772
Provider Business Practice Location Address Fax Number:
806-249-9717
Provider Enumeration Date:
08/05/2019