Provider First Line Business Practice Location Address:
1004 N DOUTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93230-3723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-582-4245
Provider Business Practice Location Address Fax Number:
559-582-4298
Provider Enumeration Date:
09/28/2006