Provider First Line Business Practice Location Address:
1122 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:
93230-2928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-627-9314
Provider Business Practice Location Address Fax Number:
559-298-0139
Provider Enumeration Date:
09/21/2005