Provider First Line Business Practice Location Address:
42540 N. 6TH STREET EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93535-5202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-951-1998
Provider Business Practice Location Address Fax Number:
661-951-1188
Provider Enumeration Date:
06/29/2005