Provider First Line Business Practice Location Address:
2433 HARBOR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VENTURA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93001-3904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-642-7811
Provider Business Practice Location Address Fax Number:
805-642-2459
Provider Enumeration Date:
07/02/2006