Provider First Line Business Practice Location Address:
5671 E KINGS CANYON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93727-6109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-253-1223
Provider Business Practice Location Address Fax Number:
559-253-1227
Provider Enumeration Date:
12/05/2005