Provider First Line Business Practice Location Address:
5893 COPLEY DR
Provider Second Line Business Practice Location Address:
DEPARTMENT OF ORTHOPAEDIC SURGERY
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92111-7906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-322-8872
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2009