Provider First Line Business Practice Location Address:
236 E KING AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULARE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93274-4110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-686-1288
Provider Business Practice Location Address Fax Number:
559-686-2553
Provider Enumeration Date:
08/30/2006