Provider First Line Business Practice Location Address:
800 N STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANGER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-875-5545
Provider Business Practice Location Address Fax Number:
559-875-1211
Provider Enumeration Date:
03/14/2006