Provider First Line Business Practice Location Address:
2752 NAVAJO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020-2121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-464-1771
Provider Business Practice Location Address Fax Number:
619-464-0160
Provider Enumeration Date:
03/28/2007