Provider First Line Business Practice Location Address:
2075 WORTH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HEMPHILL
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-787-2356
Provider Business Practice Location Address Fax Number:
409-787-4775
Provider Enumeration Date:
09/25/2006