Provider First Line Business Practice Location Address:
204 PIRIE RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023-3135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-485-3800
Provider Business Practice Location Address Fax Number:
805-485-3839
Provider Enumeration Date:
10/21/2006