Provider First Line Business Practice Location Address:
151 S 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERMAN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93630-1029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-846-5383
Provider Business Practice Location Address Fax Number:
559-846-5941
Provider Enumeration Date:
10/19/2010