Provider First Line Business Practice Location Address:
3663 WEST FIFTH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-985-1276
Provider Business Practice Location Address Fax Number:
805-382-1738
Provider Enumeration Date:
11/13/2006