Provider First Line Business Practice Location Address:
1610 E HARRISON AVE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-421-4996
Provider Business Practice Location Address Fax Number:
956-421-4998
Provider Enumeration Date:
05/10/2011