Provider First Line Business Practice Location Address:
1413 BAILEY ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93230-5943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-784-9309
Provider Business Practice Location Address Fax Number:
559-782-4681
Provider Enumeration Date:
01/13/2012