Provider First Line Business Practice Location Address:
321 C ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOORE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93245-2931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-924-2666
Provider Business Practice Location Address Fax Number:
559-924-0266
Provider Enumeration Date:
11/22/2005