Provider First Line Business Practice Location Address:
501 MUNZER ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
SHAFTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-364-5244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2015