Provider First Line Business Practice Location Address:
9720 1 2 WOODMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-896-4400
Provider Business Practice Location Address Fax Number:
818-896-1585
Provider Enumeration Date:
01/16/2007