Provider First Line Business Practice Location Address:
400 W MINERAL KING AVE
Provider Second Line Business Practice Location Address:
INPATIENT PHARMACY
Provider Business Practice Location Address City Name:
VISALIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93291-6237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-624-5647
Provider Business Practice Location Address Fax Number:
559-713-2442
Provider Enumeration Date:
08/10/2005