Provider First Line Business Practice Location Address:
142 E CALIFORNIA 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:
93706-3642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-600-1045
Provider Business Practice Location Address Fax Number:
559-600-1101
Provider Enumeration Date:
12/15/2006