Provider First Line Business Practice Location Address:
784 N LEMOORE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOORE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93245-2329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-924-5358
Provider Business Practice Location Address Fax Number:
559-924-8410
Provider Enumeration Date:
05/27/2006