Provider First Line Business Practice Location Address:
2100 E CLINTON 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:
93703-2134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-224-5988
Provider Business Practice Location Address Fax Number:
559-224-5933
Provider Enumeration Date:
09/28/2006