Provider First Line Business Practice Location Address:
6301 OWENSMOUTH AVE
Provider Second Line Business Practice Location Address:
#200 THE WELLNESS CENTER
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91367-2216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-704-2914
Provider Business Practice Location Address Fax Number:
818-712-2100
Provider Enumeration Date:
08/17/2006