Provider First Line Business Practice Location Address:
4129 N 22ND ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-992-0444
Provider Business Practice Location Address Fax Number:
956-992-0403
Provider Enumeration Date:
02/06/2008