Provider First Line Business Practice Location Address:
845 ARMADA TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92106-3055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-223-6037
Provider Business Practice Location Address Fax Number:
619-226-0400
Provider Enumeration Date:
12/27/2010