Provider First Line Business Practice Location Address:
24900 HIGHWAY 202
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:
93581-1031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-822-4402
Provider Business Practice Location Address Fax Number:
661-822-5004
Provider Enumeration Date:
07/06/2007