Provider First Line Business Practice Location Address:
201A WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COALINGA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93210-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-935-2111
Provider Business Practice Location Address Fax Number:
559-935-1281
Provider Enumeration Date:
09/11/2006