Provider First Line Business Practice Location Address:
2615 E CLINTON AVE
Provider Second Line Business Practice Location Address:
MEDICAL SERVICE (111)
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93703-2223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-228-5327
Provider Business Practice Location Address Fax Number:
559-241-6484
Provider Enumeration Date:
07/31/2006