Provider First Line Business Practice Location Address:
115 W DUNNAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOBBS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88240-6020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-393-8201
Provider Business Practice Location Address Fax Number:
505-393-1318
Provider Enumeration Date:
10/12/2006