Provider First Line Business Practice Location Address:
1 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDWARDS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93524-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-676-2333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2009