Provider First Line Business Practice Location Address:
MARTIN MIDDLE SCHOOL
Provider Second Line Business Practice Location Address:
1601 HASKELL ST
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-414-3243
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2022