Provider First Line Business Practice Location Address:
410 W J ST STE A
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:
93561-1411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-642-6942
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2008