Provider First Line Business Practice Location Address:
314 W 4TH ST.
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:
805-988-1112
Provider Business Practice Location Address Fax Number:
805-988-4883
Provider Enumeration Date:
03/20/2007