Provider First Line Business Practice Location Address:
CA STATE UNIVERSITY FRESNO
Provider Second Line Business Practice Location Address:
5044 N. BARTON AVE MS HC81
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93740-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-278-6722
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2006