Provider First Line Business Practice Location Address:
1800 SCURRY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79720-5402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-268-1711
Provider Business Practice Location Address Fax Number:
432-264-0599
Provider Enumeration Date:
07/20/2006