Provider First Line Business Practice Location Address:
101 N IRWIN ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
HANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93230-4570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-585-8909
Provider Business Practice Location Address Fax Number:
559-585-8914
Provider Enumeration Date:
01/06/2010