Provider First Line Business Practice Location Address:
975 EAST ADAMS AVENUE
Provider Second Line Business Practice Location Address:
(ROOMS 1-5,OFFICES 1-3)
Provider Business Practice Location Address City Name:
FOWLER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-885-5580
Provider Business Practice Location Address Fax Number:
888-885-5580
Provider Enumeration Date:
02/22/2011