Provider First Line Business Practice Location Address:
1990 S A ST
Provider Second Line Business Practice Location Address:
PINACATE MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
PERRIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92570-4507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-294-5882
Provider Business Practice Location Address Fax Number:
951-294-5806
Provider Enumeration Date:
12/12/2012