Provider First Line Business Practice Location Address:
400 TUCKER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561-2578
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-825-2260
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2024