Provider First Line Business Practice Location Address:
1616 CALLAGHAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-435-1218
Provider Business Practice Location Address Fax Number:
210-435-3162
Provider Enumeration Date:
07/21/2006