Provider First Line Business Practice Location Address:
237 W SHIELDS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93705-4104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-227-4120
Provider Business Practice Location Address Fax Number:
559-228-6831
Provider Enumeration Date:
09/14/2006