Provider First Line Business Practice Location Address:
432 W J ST
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-1311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-822-4421
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2007