Provider First Line Business Practice Location Address:
22620 WAHTOKE AVE
Provider Second Line Business Practice Location Address:
ROOMS 5,9,17
Provider Business Practice Location Address City Name:
REEDLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93654-9604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-221-8100
Provider Business Practice Location Address Fax Number:
559-221-8101
Provider Enumeration Date:
12/04/2014