Provider First Line Business Practice Location Address:
1201 N DOUTY
Provider Second Line Business Practice Location Address:
EARL F JOHNSON HIGH SCHOOL
Provider Business Practice Location Address City Name:
HANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93230-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-251-4800
Provider Business Practice Location Address Fax Number:
559-453-7827
Provider Enumeration Date:
11/26/2014