Provider First Line Business Practice Location Address:
5430 N PALM
Provider Second Line Business Practice Location Address:
#108 ST JOSEPH COUNSELING CENTER
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-438-1200
Provider Business Practice Location Address Fax Number:
559-438-1413
Provider Enumeration Date:
10/25/2006