Provider First Line Business Practice Location Address:
145 S FIG 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:
92025-4453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-480-9709
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2007