Provider First Line Business Practice Location Address:
118 SO. ROBINSON STREET
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:
93561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-823-9215
Provider Business Practice Location Address Fax Number:
661-823-9243
Provider Enumeration Date:
03/17/2009