Provider First Line Business Practice Location Address:
115 N IRWIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93230-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-584-4227
Provider Business Practice Location Address Fax Number:
559-584-4785
Provider Enumeration Date:
11/09/2006