Provider First Line Business Practice Location Address:
23928 LYONS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWHALL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91321-2409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-254-7216
Provider Business Practice Location Address Fax Number:
661-254-4830
Provider Enumeration Date:
01/20/2008