Provider First Line Business Practice Location Address:
101 E BUSH ST
Provider Second Line Business Practice Location Address:
ROOMS C-3, ANNEX, 7-8
Provider Business Practice Location Address City Name:
LEMOORE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93245-3601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-221-8100
Provider Business Practice Location Address Fax Number:
559-221-8101
Provider Enumeration Date:
06/04/2009