Provider First Line Business Practice Location Address:
1101 E UNIVERSITY 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:
93741-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-442-8268
Provider Business Practice Location Address Fax Number:
559-499-6050
Provider Enumeration Date:
03/08/2023