Provider First Line Business Practice Location Address:
659 S CENTRAL VALLEY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAFTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-459-1900
Provider Business Practice Location Address Fax Number:
661-459-1974
Provider Enumeration Date:
02/04/2008