Provider First Line Business Practice Location Address:
701 CENTRAL VALLEY HWY SUITE B & C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAFTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93263-2028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-237-6100
Provider Business Practice Location Address Fax Number:
661-237-6105
Provider Enumeration Date:
03/02/2007