Provider First Line Business Practice Location Address:
320 JAMES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAFTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93263-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-459-1814
Provider Business Practice Location Address Fax Number:
661-459-1821
Provider Enumeration Date:
05/31/2005