Provider First Line Business Practice Location Address:
1205 GARCES HWY STE 102
Provider Second Line Business Practice Location Address:
MEDICAL ARTS BUILDING
Provider Business Practice Location Address City Name:
DELANO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93215-3657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-721-3530
Provider Business Practice Location Address Fax Number:
661-721-3533
Provider Enumeration Date:
05/05/2007