Provider First Line Business Practice Location Address:
9300 VALLEY CHILDRENS PLACE
Provider Second Line Business Practice Location Address:
CHARLIE MITCHELL CHILDRENS CLINIC MB01
Provider Business Practice Location Address City Name:
MADERA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93636-3227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-353-5052
Provider Business Practice Location Address Fax Number:
559-353-8180
Provider Enumeration Date:
02/27/2006