Provider First Line Business Practice Location Address:
2085 E DAKOTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93726-4804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-453-4405
Provider Business Practice Location Address Fax Number:
559-453-5111
Provider Enumeration Date:
07/03/2008