Provider First Line Business Practice Location Address:
3660 E DAKOTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93726-5043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-228-1200
Provider Business Practice Location Address Fax Number:
559-224-3595
Provider Enumeration Date:
02/19/2007