Provider First Line Business Practice Location Address:
501 W KERN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC FARLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93250-1354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-792-3028
Provider Business Practice Location Address Fax Number:
661-792-3564
Provider Enumeration Date:
01/03/2007