Provider First Line Business Practice Location Address:
20115 RIMROCK ROAD EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APPLE VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-242-7340
Provider Business Practice Location Address Fax Number:
760-242-7340
Provider Enumeration Date:
06/03/2010