Provider First Line Business Practice Location Address:
20601 CALIFORNIA HIGHWAY 202
Provider Second Line Business Practice Location Address:
A103
Provider Business Practice Location Address City Name:
TEHACHAPI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-609-5998
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2023