Provider First Line Business Practice Location Address:
1101 W TEHACHAPI BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-2559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-784-1011
Provider Business Practice Location Address Fax Number:
661-826-2502
Provider Enumeration Date:
12/14/2011