Provider First Line Business Practice Location Address:
8004 ABBEVILLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUBBOCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79424-2806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-794-0400
Provider Business Practice Location Address Fax Number:
806-794-0833
Provider Enumeration Date:
03/26/2007