Provider First Line Business Practice Location Address:
239 S JUNIPER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92025-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-480-4080
Provider Business Practice Location Address Fax Number:
760-480-4081
Provider Enumeration Date:
03/03/2014