Provider First Line Business Practice Location Address:
254 N KESSING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTERVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93257-3424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-781-8500
Provider Business Practice Location Address Fax Number:
559-781-8300
Provider Enumeration Date:
10/12/2006