Provider First Line Business Practice Location Address:
22 N COTTAGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTERVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93257-3220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-784-8500
Provider Business Practice Location Address Fax Number:
559-782-5667
Provider Enumeration Date:
12/06/2006