Provider First Line Business Practice Location Address:
111 PIUTE DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERNVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93238-0097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-376-2216
Provider Business Practice Location Address Fax Number:
760-376-3858
Provider Enumeration Date:
04/26/2016