Provider First Line Business Practice Location Address:
1122 N HARRIS ST
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
HANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93230-3785
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-582-0141
Provider Business Practice Location Address Fax Number:
559-582-4829
Provider Enumeration Date:
07/01/2006