Provider First Line Business Practice Location Address:
1001 W TEHACHAPI BLVD
Provider Second Line Business Practice Location Address:
SUITE A-100
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-2532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-822-2530
Provider Business Practice Location Address Fax Number:
661-822-2536
Provider Enumeration Date:
03/21/2007