Provider First Line Business Practice Location Address:
22721 WOODFORD TEHACHAPI RD
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:
93561-7938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-439-6526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/14/2011