Provider First Line Business Practice Location Address:
209 E 10TH 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:
93230-3943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-670-9249
Provider Business Practice Location Address Fax Number:
559-245-7853
Provider Enumeration Date:
12/30/2025