Provider First Line Business Practice Location Address:
2145 E CARDELLA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FIREBAUGH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93622-2519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-696-3510
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/23/2014