The most important function of the intestinal barrier is to balance the absorption of nutrients, electrolytes and water from the lumen into the blood flow and to prevent the entry of pathogenic microorganisms and toxic luminal substances. Additional regulation of this exchange of molecules between the environment and the host over the intestinal barrier affects the balance between immunity and tolerance to both self and non-self-antigens.
What’s the significance of intestinal barrier function?
From a structural standpoint, intestinal barrier function is maintained by many components like a mucous coating and a single layer of epithelial cells connected with tight junctions. The mucus layer is made up of secretory immunoglobulin (Ig) A and antimicrobial peptides which cover the epithelial cell lining to ease gastrointestinal transport, or GI transport, and provide a protective coating against bacterial invasion. The colonic mucous coating consists of two layers, an outer and inner layer consisting of gel forming highly glycosylated proteins known as mucins. These are generated and preserved by goblet cells which repair the internal mucus layer roughly every hour. These dynamic procedures are subject to extensive and constant interactions between the gut microbiota, where the disruption of such may have consequences for the sustenance of crucial intestinal barrier function.
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Tight junctions are complex protein structures which contain transmembrane proteins like claudin, occludin, and tricullulin. These transmembrane proteins connect with all the opposing plasma membrane, forming a mechanical network between epithelial cells and establishing a barrier for the paracellular diffusion of fluid and solutes. The structure of the intestinal barrier is shaped by the end of the first trimester. Epithelial cells with microvilli, goblet and enteroendocrine cells, develop by week eight of gestation and tight junctions can be observed from week ten. Functional development of the intestinal barrier continues from the post natal period and can be affected by both feeding diet and mode. By way of instance, as demonstrated to be exemplified by the underdeveloped intestinal barrier of a premature baby, disruptions in the development process of the intestinal barrier can predispose the infant to immune disorders.
The gut microbiota, from the first days of life, is unstable and not especially varied in its own make-up. By age three, however, the microbiota composition resembles the adult-like profile. Many different factors might also influence the course of microbiota growth, such as gestational age, mode of delivery, type of feeding, antibiotic usage, and exposure to family members and pets. The intestinal barrier functions as a shield that may be altered by the gut microbiota or its metabolites. The mechanisms underlying the balance of the epithelial barrier can be complicated. Recent evidence also indicates a novel role for non-coding RNAs, like microRNAs, as important intermediaries for the connections between host epithelial cells, immune cells and the gut microbiota. Alterations to the gut microbiota are correlated with concomitant gut barrier dysfunction in both intestinal and extra-intestinal diseases. The role of the gut microbiota in disrupting the intestinal barrier in stress-related neuropsychiatric conditions, such as depression, hasn’t been completely researched.
Brain-Gut Microbiota Axis
Interactions between the gut and the brain are controlled at nerve, endocrine, and immune levels of the human body. These pathways are within the effect of the gut microbiota and collectively, they include the brain-gut-microbiota axis. An essential purpose of the gut microbiota is the development and balace of the intestinal barrier throughout an individual’s lifespan. It’s possible that subtle alterations within microbiota expenditure or care in early life might serve a vulnerability factor, affecting (neuro)endocrine and (neuro)immune signaling pathways of the brain-gut-microbiota axis, which can then predispose individuals to stress-related diseases during adulthood. Animals devoid of gut microbiota show reduced levels of anxiety but an exaggerated neuroendocrine response to stress. The most evident impact created by the microbiota might happen early in life through crucial neurodevelopmental phases. It’s clear that the gut microbiota is needed for the normal development of the hypothalamic pituitary adrenal, or HPA, axis and there appears to be a definite period in early life when colonization should occur to ensure normal development of the crucial stress signaling pathway. A theory suggests that restricting less microbial biodiversity can lead to the growth in chronic inflammatory diseases, like some subtypes of depression.
The interaction between the immune system, the gut microbiota and the intestinal barrier might be of specific value to health in the opposite extreme of aging. Aging is characterized by long-term inflammation, termed “inflammaging”, according to elevated circulating levels of Tumor necrosis factor-alpha, or TNF-α, interleukin-6, or IL-6 and C-reactive protein, CRP; inflammatory molecules known to influence mood and cognition. Due to the simple fact that the gut microbiota are crucial regulators of immune function and inflammatory reactions, it’s possible that an alteration in the composition of the gut microbiota during aging plays a part in the slow activation of their immune system and inflammaging, potentially through an effect on intestinal permeability. It’s been demonstrated that the elderly have a different microbiota profile, characterized by larger inter-individual variations in comparison to younger adults. Needless to say, differences in microbiota composition were more pronounced between frail elderly subjects and healthy elderly subjects. Additionally, certain gut microbiota signatures have been connected to measures of frailty, co-morbidity, nutrient status, and markers of inflammation.
Intestinal Barrier Function and Stress
Stress can affect the developmental progress of the intestinal barrier, which has also been associated with an increase in intestinal permeability. The consequences of stress on intestinal permeability are complicated and are believed to involve the gut and the brain. Corticotrophin releasing factor, or CRF, and its receptors (CRFR1 and CRFR2), play an integral role in stress-induced intestinal permeability dysfunction. In reaction to an acute stressor, colonic paracellular permeability increases and may be connected to the growth of visceral hypersensitivity. At a mouse model of chronic depression, elevated central CRH expression occurred concomitantly with alterations from the gut microbiota.
Early life stress has also been proven to boost plasma corticosterone in rat pups and is connected with an increase in intestinal permeability and bacterial translocation into the liver and spleen. This effect seemed to predominate in the colon. Naturally, stress-induced changes in the HPA axis and autonomic nervous system screen sensitivity to probiotic intervention (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175). Furthermore, these probiotics additionally revived colonic tight junction integrity in stressed mice. Probiotics have further been proven to affect bacterial adhesion and translocation to mesenteric lymph nodes in reaction to stress. Lactobacillus farciminis, by way of instance, not merely inhibits stress-induced changes in permeability, HPA axis activity, endotoxaemia, and neuroinflammation, but also beneficially affects the mucus barrier. Human studies also confirmed that acute-stress paradigms can influence intestinal permeability. During a public talking based stressor, little intestinal permeability was significantly improved, however, this was only observed in subjects who also reacted with a substantial elevation of cortisol. In a contrasting acute stress model utilizing a cold pain stressor, albumin permeability increased, though only in females.
Stressful early-life situations are strongly connected to the development of depression later in life. The interaction between stress, the HPA axis and the immune system is well recognized. In the past few years it has been discovered that the gut microbiota mediates this interaction. Early-life maternal separation, by way of instance, leads to a significant reduction in the amount of fecal Lactobacillus three days post-separation, associated with stress-related behaviors. At a mouse model of societal disturbance, stress-induced alterations in the microbiota were accompanied by changes in cytokine and chemokine levels. Many different research studies have confirmed that stress can change gut microbiota composition. This is also related prenatally, as babies of mothers with elevated self-reported stress and high salivary cortisol levels throughout pregnancy had a higher relative amount of Proteobacteria and lower relative amounts of lactic acid bacteria (Lactobacillus, Lactoccus, Aerococcus) and Bifidobacteria. But, it’s unclear if this effect was mediated through esophageal parasitic transmission or via microbiota-independent situations. Nonetheless, those babies with altered microbiota composition exhibited a greater degree of GI symptoms and allergies, highlighting the practical effects of abnormal colonization patterns in early life. Recent preclinical evidence demonstrated that maternal stress altered the vaginal microbiota, diminishing Lactobacillus, with consequences on its metabolic profile and neurodevelopment in the offspring.
A dysfunctional intestinal barrier may allow a microbiota driven proinflammatory condition with consequences for the brain, as seen on Figure 1. The progress of the course of action isn’t yet very clear. An increase in intestinal permeability could predict mucosal inflammation to cause the inflammatory reaction and end up at a feed-forward cycle involving inflammatory reactions and intestinal barrier dysfunction. This may then maintain and exacerbate the very low grade inflammatory reaction. Alternately, systemic inflammation can improve intestinal barrier permeability and allow translocation of commensal bacteria with additional consequences for systemic inflammation. The origin of the very low grade inflammation that has been reported in depression hasn’t yet been isolated to a certain source.
Greater IgA- and – IgM-mediated immune reactions directed against lipopolysaccharides, or LPS, of specific commensal g negative gut bacteria have been demonstrated in depressed patients. The implication being that the existence of these reactions may have occurred following the disturbance of the intestinal barrier. Additionally, bacterial DNA was discovered in whole serum from patients with depression that also demonstrated increased Toll-like receptor (TLR)-4 expression on peripheral mononuclear blood cells when compared with healthy controls.
Two printed cross sectional studies have researched the gut microbiota composition in depression. The first discovered that an increase in Bacteroidales along with a reduction in Lachnospiraceae compared to controls. But, there have been no major differences in species richness, α-diversity, or operational taxonomic units. In the next study, increased amounts of Enterobacteriaceae and Alistipes were detected. Moreover, Fecalibacterium amounts decreased in the depressed group and negatively correlated with severity of depressive symptoms. From the context of alcohol abuse, a connection between the gut microbiota, intestinal barrier function and comorbid depression has just been reported. Microbiota-derived LPS and peptidoglycans, or PGN, were proven to cross the intestinal barrier and trigger their various receptors, including TLR4 and TLR2 in peripheral blood mononuclear cells. Although chronic alcohol ingestion inhibited the NF-κB pathway, it triggered protein kinase/activator protein pathway and IL-8 and IL-1B. By comparison, short-term alcohol withdrawal has been connected to the retrieval of TLR4 receptors. The identical group also revealed that increased intestinal permeability happened in a sub group of alcohol-dependent subjects that were associated with greater depression and anxiety scores in addition to a modified gut microbiota profile.
Information referenced from the National Center for Biotechnology Information (NCBI) and the National University of Health Sciences. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
These canons of professional ethics are based upon fundamental principles of moral and professional behavior and recommended for all doctors of chiropractic and chiropractic assistants. The following basic principles should be guiding factors in the practice of chiropractic and upheld at all times:
Consider the well-being of the patient. The primary effort and ultimate goal is for the greatest good of our patients.
- Dr. Alexander D. Jimenez D.C., C.C.S.TChief Clinical DirectorPhone: 9155408444Email: firstname.lastname@example.org
Specializing in Severe Pain: Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sport Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven therapies focused on optimal mobility, health, fitness, and structural conditioning. We use Patient Focused Diet Plans, Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols and the "PUSH System" to treat patients suffering from various injuries and health problems.
Message from: Dr. Alex Jimenez D.C., C.C.S.T
( Biography and my promise to you )
My name is Dr. Alex Jimenez, I am Chiropractic Doctor specializing in advanced therapies focused on total joint health, strength training and complete fitness conditioning. We use patient Focused Diet Plans, Advanced Chiropractic Techniques, Agility Training, Cross-Fit and the PUSH System to treat patients suffering from various injuries and health problems. Our goal too is to help your body heal itself naturally. When your body is truly healthy, you will arrive at your fitness level and proper weight efforlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25+ years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs...
My goal too is to help the body heal itself naturally. When your body is truly healthy and balanced, you will move pain free and ultimatly arrive at your optimal fitness levels and proper weight effortlessly. We want to help educate you on how to live a new and improved lifestyle. Our doctors have spent over 25 years researching and testing methods with thousands of patients. We strive to create fitness and better the body through researched methods and total programs. These programs are natural, and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life.
The focus on spinal and skeletal adjustments is what makes doctors of chiropractic unique in their approach to treating patients with spinal complaints. This hallmark chiropractic adjustment, however, is not the only procedure a chiropractor may employ in managing a patient's care. I am very proud to bring my patients a variety of treatment options beyond the typical scope of care. With the advances in physical therapies and modalities we bring El Paso option that better aid in the rehabilitation process. Tissue healing is a wonderful process that begins the moment an injury occurs. How the injury is managed determine the final outcome in terms of healing. It is critical we implement immediate procedures as soon as we can in order to gain optimal recovery. The old day of let it rest until it gets better is not the only option.
Letting it rest may even be an irresponsible approach considering what we now know. The implementation of active and movement based treatments have clearly shown increased and improved outcomes in many instances.
As a doctors focused on the greater good for a patient, we must assess each patient individually and apply the appropriate protocols. It is also very important to denote, that El Paso has fine doctors in many specialties of healing and repair. The direct relationship we have with specialist of these disciplines is clearly what allows us to bring the highest quality of care to our patients.
My promise to my patients is clear for all to read here. I, with Gods help, will do what ever it takes to assist you in your recovery. I too will draw upon all the specialist in this town to find you the collaborative care that is required with the disorders being tended to.
With Great Regards to you.Read moreRead lessEducation:
Affiliations and Certifications:
- Texas Chiropractic Association
- Chiropractic Care
- Physical Therapy
- Strength Training
- Crossfit Doctor
- Return to Competition Rehabilitation
- Truide TorresExecutive Director / Patient LiasonPhone: 9152526149Email: email@example.com
Director: Patient Relations Advocate Dept.
Truide has been working for the past 20 years in claims resolutions. She works hand in hand with patients and is availible to resolve dispute resolutions.
Truide Torres (Bio)
Driven by the passion of doing what is in the best interest of the patient, I wake up every morning with the drive to help those in need. The claims process for health care is full of pits, valleys and difficult obstacles designed to strike fear in those in need. My duty is to do what is within the confines of the law, "what ever it takes" to get those involved to pay attention to those who need help. That is what I am honored to do for our patients.
Personally, I have seen great injustices transpire on those that do NOT have a voice. Whether, a language barrier or just not knowing the rules. My job is to find out how I can help. If I personally can not help, I will find the right sources to open the possibilities. I get the job done.
As a wife and mother of 2 children, 3 dogs and 2 Cats. My passion is for God, Family and the mission of serving my fellow man.
Let it be clearly stated... I am here to help. My phone 915-850-0900Read moreRead less
- Daniel AlvaradoExercise PhysiologistPhone: 9152038122Email: firstname.lastname@example.org
Daniel Alvarado is the owner and the top trainer at PUSHasRx® CrossFit Fitness Facility. Since becoming a Trainer Daniel has kept up to date on many continuing educational classes, ensuring that his clients receive the most comprehensive and advanced training. Working directly with the Doctors, he develops and collaborates on care plans that are patient specific. No patient ever gets the same clinical protocol. His expert clinical kinesiology experience spans over 2 decades. He has trained injured patients and NCAA National Champion Athletes. His technical ability to create programs that are clinically sound and second to none. He too has used his physical therapy and recovery experience to take broken top tier athletes into strict recovery protocols assisting them to achieve highly competitive national championships. He certainly will not admit it but, he is a top national champion trainer. Daniel, also develops youth programs that are sport specific to aid young athletes achieve great success. His mastery of clinical recovery is applied applied to all patients and top tier athletes alike. All patient programs are specifically designed with patient focused recovery priorities. He is happily married to beautiful Victoria Alvarado has one child. He enjoys strength training, movies, singing, conducting, writing poetry and being a CrossFit champion. Just a way cool dude. We think you will agree.Read moreRead less
- Dennise AcostaHead Office ManagerPhone: 915-850-0900Email: email@example.com
Dennise has been at Injury Medical & Chiropractic Clinic for four years. Known as the master multi-tasker. Dennise, handles patient care from the moment you walk in the door. She is akin to the air traffic controller. She will assist you in matter requiring clinical preparation and effective inter-office communication. She unifies all department and clinical providers making sure all important information reaches all clinicians in a timely manner. She also loves to work out, stay in shape, watch movies and help people.Read moreRead less
- Sandra MartinezHead Clinical TherapistPhone: 915-850-0900Email: firstname.lastname@example.org
Sandra has been working at Injury Medical & Chiropractic Clinic for over 5 years. As the head Licensed Massage Therapist, she manages and directs critical aspect of clinical care. The patients love her ability to make you laugh while removing those pesky trigger points causing pain. She is able to relax and bring comfort to all she touches. There just simply is no patient that escapes her talented touch. Trained in advance myofascial techniques, she is an integral part of patient recovery. You will never see anything but a kind smile and resolute persona ready to correct your condition and aid in your recovery. She definitely enjoys helping people, has 1 dog and loves movies. She loves flowers too.Read moreRead less
- AlejandraBilling AgentPhone: 915-850-0900Email: email@example.com
Alejandra works in accounts & billing. She is the radar of the bunch. Nothing appears to escape her mind. Highly intelligent and appears not to need a computer for recall of facts. She provides information retrieval for patients and clinical staff. She has been at Injury Medical & Chiropractic Clinic for three years and ready for any task at hand. She performs interoffice communications with attorneys and medical director of ancillary offices. She loves her family and places know how to prioritize well.Read moreRead less
- Mike ContrerasPersonal TrainerPhone: 915-203-8122
Big Mike was born and raised in El Paso and is an excellent personal trainer and CrossFit coach. Mike works hand in hand with each patient’s clinical care plan in order to achieve optimal outcomes. A trusted clinical representative of the PUSHasRx System along with his advance protocols. Mike not only trains the injured and recovering. Mike is a sincere human that has great talent of brining out the best in every individual he works with. He will never admit it, but we will share with you a secret. He with his God given talents trains the greatest athletes and champions in El Paso. Many champions in our community know of his commitment. As a youth, he also played football (wide receiver), basketball, and track at Bel Air High School. Educated in Clinical Human Kinesiology at UTEP and loves playing football and basketball with his little nephews in his free time. Mike has three sisters and one brother, most of which live nearby in El Paso. When he’s not watching the Cowboys or Spurs play, he’s usually lifting, sleeping or watching movies. We are blessed to have this soul on our team.Read moreRead less
- Alexander Isaiah JimenezCollegiate Athletic Consultant & NCAA Wrestling ChampionPhone: 915-820-9443Email: firstname.lastname@example.org
Alexander Isaiah Jimenez leads the power and agility education programs for the high school athletes. While still studying for his medical degree he provides physical performance testing in order to collaborate with clinicians. He is gifted in creating physical performance programs no matter what the clinical presentation is. As national fitness champion and collegiate wrestler, he too understands what performing at high levels entails. He too has had to recover from debilitating injuries only to return better then before an win national titles. He understand how the recovery process is different for clients, patients and extreme athletes. We are blessed to have his counsel.Read moreRead less
- Ethan PadillaPersonal Trainer & Strength CoachPhone: 915-203-8122
Ethan was born and raised in El Paso and is one of our most outgoing and friendly coaches. Ethan earned his nickname “rampage Ethan” from his years at El Dorado High School, where he played inside linebacker. He has placed twice in the Strongman Competition and also recently competed in the Desert Games with his fellow PUSH Athletes as a team and placed 4th overall! Ethan is currently pursuing his Bachelor’s Degree in Kinesiology at UTEP. His focus on clients is obvious to all. Ethan is able to manage very large groups of individuals like no other. His awareness of the dangers while exercising is his greatest concern. When he’s not coaching or studying for class, he likes to spend time with his family (who are here in El Paso) or with his weimaraner puppy. Fun fact: Ethan loves any food with sprinkles (especially donuts with sprinkles) and is a diehard Seattle Seahawks fan.Read moreRead less
- AndresRecovery & Nutrition
Andres has been at PUSHasRx for two years. He brought his company Recovery and became the official juicer. Andy will fix you right up. Andres, will make sure that your nutritional recovery programs fits within your standards. Also, there is great care in making sure the nutritional requirement are clinically met. Patients and high performance athletes depend on high performance nutritions. Upon your completion of the physical medicine portion of therapy you will be offered specialized organic recovery drinks and supplementation to help aid in your recovery. You will be confident that from your pushing to recovery, you will be taken care of.Read moreRead less
- Iylene AvalosPUSHasRx TrainerPhone: 915-203-8122
ylene has been working with us for over 4 years. In her spare time she enjoys working out and running. She has 2 dogs and loves movies. Iylene is extremely aware of body mechanics and mindfully watches rehabilitation movements. She is always standing ready to assist and respond to client needs. Her commanding voice is always clear to all, no matter what floor you are on. Iylene is always ready and willing to answer any question you may have regarding fitness and recovery.Read moreRead less
- Rick CanoPersonal Trainier Level VPhone: 915-203-8122
Most early-rising PUSHasRx members know Rick well as a fantastic coach who focuses strongly on form and will always make you laugh. He was born and raised in El Paso and loves to train his athletes and coach CrossFit. Rick is a very diligent, kind and considerate trainer. He is always mindful of client techniques and aware of client goals. When he’s not coaching, Rick loves to work on cars, especially his ’69 Chevelle (his next car will hopefully be a ’69 Charger). He not only became a certified Automotive Mechanic at 17, but while working on his certification at EPCC, he won 1st place in a bench competition when he was 16 (approx. 56 reps at 155#). His favorite movements are clean & jerks and snatches. He loves oreos (eats them every night), loves watching the CrossFit games, and loves his three bulldogs. He spent one year full-time personal training before he started coaching CrossFit two years ago. He is CrossFit Level 1 Certified and hopes to get his Level 2 Certification soon. Rick has competed in several competitions, including WOD for Toys in 2014, where his team placed 1st.Read moreRead less
- Astrid OrnelasBlogger/Research/CuratorPhone: 915-850-0900
Astrid has been at Injury Medical & Chiropractic Clinic for about three years. Astrid has taken her love for writing to an new level. She is a gifted and talented copywriter able to create amazing storylines. She creates content for patient consumption. She is able to bring words to life in a way that perplexes even the elite authors of the day. She loves nutrition and the healing power of clean eating. A naturalist at heart you will never see her eating processed foods that would be contra to clean living. She enjoys movies and creating storylines for Anime.Read moreRead less
- AdamVideographer & Graphics SpecialistPhone: 915-850-0900
Adam has been at Injury Medical & Chiropractic Clinic for about a year. He enjoys designing and various forms of art. A story teller by trade he can see things people don’t see until his masterpieces are revealed. Adam is a director of many medias using the top graphics, audio and video medias to tell the story of our patient. Modest to the core, you would never know what he is about to create. We are blessed to have his talents telling the world about Chiropractic using any and all medias available.Read moreRead less
- Our PassionsEmail: email@example.com
We Welcome You 👊🏻.
Purpose & Passions: I am a Doctor of Chiropractic specializing in progressive cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, functional strength training and complete conditioning. We focus on restoring normal body functions after neck, back, spinal and soft tissue injuries.
We use Specialized Chiropractic Techniques, Balanced Diet Plans, Agility Training programs, Cross-Fit techniques, the PUSH-Rx Rehabilitation System and a highly specialized program for our Veterans.
We've been blessed to use our methods with thousand of El Pasoans over the last 27 years. This has allowed us to improve health and restore true fitness through researched non-surgical methods and wellness programs. These programs are natural and use the body's own ability to achieve goals of improvement, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and informed on how to maintain this way of life.
As an extension to dynamic rehabilitation, we too offer our patients, disabled veterans, athletes, young and elder a diverse portfolio of strength equipment, high performance exercises and advanced agility options. We are very proud to have teamed up with the cities premier therapist and trainers in order to provide high level competitive athletes the option to push themselves to their highest abilities within our facility.
Come learn how to improve your health for yourself and your loved ones.
With a bit of work, we can achieve optimal health together, no matter the age or disability.
Its all about: LIVING, LOVING & MATTERING! 🍎
2 CONVENIENT LOCATIONS:
(LOCATION#1) CENTRAL ELPASO:
6440 Gateway East, Suite B
(LOCATION#2) EAST SIDE ELPASO:
11860 Vista Del Sol, Suite 128
PHONE: 915-850-0900 ✔️Read moreRead less