Provider First Line Business Practice Location Address:
13400 SABRE SPRINGS PKWY
Provider Second Line Business Practice Location Address:
SUITE 275
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92128-4198
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-248-4079
Provider Business Practice Location Address Fax Number:
828-386-7259
Provider Enumeration Date:
11/20/2012