Provider First Line Business Practice Location Address:
22917 SOLEDAD CANYON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91350-2633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-575-7113
Provider Business Practice Location Address Fax Number:
661-476-5278
Provider Enumeration Date:
05/06/2009