Provider First Line Business Practice Location Address:
215 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLETON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93465-8764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-434-5800
Provider Business Practice Location Address Fax Number:
805-434-1473
Provider Enumeration Date:
10/15/2026