Provider First Line Business Practice Location Address:
3443 W SHAW AVE
Provider Second Line Business Practice Location Address:
SULLIVAN CENTER FOR CHILDREN
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93711-3249
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-271-1176
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/01/2010