Provider First Line Business Practice Location Address:
825 NORTH 10TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA PAULA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-933-8600
Provider Business Practice Location Address Fax Number:
805-933-8664
Provider Enumeration Date:
01/25/2007