Provider First Line Business Practice Location Address:
247 W HARVARD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA PAULA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93060-3223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-525-0907
Provider Business Practice Location Address Fax Number:
805-933-3392
Provider Enumeration Date:
09/16/2006