Provider First Line Business Practice Location Address:
1112 C STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REEDLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93654-3015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-638-6321
Provider Business Practice Location Address Fax Number:
559-638-5014
Provider Enumeration Date:
05/22/2008