Provider First Line Business Practice Location Address:
851 W MORTON AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
PORTERVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93257-3185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-781-2222
Provider Business Practice Location Address Fax Number:
559-781-2143
Provider Enumeration Date:
03/12/2007