Provider First Line Business Practice Location Address:
21309 QUAIL SPRINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-9565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-433-2892
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2026