Provider First Line Business Practice Location Address:
116 W F ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-1614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-823-3070
Provider Business Practice Location Address Fax Number:
661-823-3090
Provider Enumeration Date:
10/18/2007