Provider First Line Business Practice Location Address:
42220 LAKE HUGHES ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE HUGHES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-724-1211
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2013