Provider First Line Business Practice Location Address:
1101 W TEHACHAPI BLVD
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:
93561-2559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-823-0163
Provider Business Practice Location Address Fax Number:
661-823-0742
Provider Enumeration Date:
01/10/2012