Provider First Line Business Practice Location Address:
603 3RD ST
Provider Second Line Business Practice Location Address:
ROOMS 25 & 26
Provider Business Practice Location Address City Name:
PARLIER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93648-2028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-221-8100
Provider Business Practice Location Address Fax Number:
559-221-8101
Provider Enumeration Date:
10/18/2007