Provider First Line Business Practice Location Address:
609 MEDICAL CENTER DR STE 500
Provider Second Line Business Practice Location Address:
C/O WISE REGIONAL HEALTH SYSTEM
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-626-4000
Provider Business Practice Location Address Fax Number:
940-626-0158
Provider Enumeration Date:
11/02/2006