Provider First Line Business Practice Location Address:
1 MONACHE DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KERNVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-376-2001
Provider Business Practice Location Address Fax Number:
760-376-4891
Provider Enumeration Date:
05/31/2005