Provider First Line Business Practice Location Address:
3551 ROGER BROOKE DRIVE
Provider Second Line Business Practice Location Address:
RHEUMATOLOGY CLINIC
Provider Business Practice Location Address City Name:
FORT SAM HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78234-6272
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-916-0797
Provider Business Practice Location Address Fax Number:
210-916-5222
Provider Enumeration Date:
10/28/2008