Provider First Line Business Practice Location Address:
234 C ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOORE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93245-2948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-924-0514
Provider Business Practice Location Address Fax Number:
559-924-0516
Provider Enumeration Date:
03/13/2012