Provider First Line Business Practice Location Address:
3000 WEST CECIL AVENUE
Provider Second Line Business Practice Location Address:
KERN VALLEY STATE PRISON
Provider Business Practice Location Address City Name:
DELANO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93216-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-721-6300
Provider Business Practice Location Address Fax Number:
661-721-6334
Provider Enumeration Date:
02/17/2011