Provider First Line Business Practice Location Address:
814 CLEARVIEW ST
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:
93561-2351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-749-4982
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2026