Provider First Line Business Practice Location Address:
2491 EAST ANAHEIM STREET
Provider Second Line Business Practice Location Address:
# 3
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-989-1322
Provider Business Practice Location Address Fax Number:
562-989-1322
Provider Enumeration Date:
07/03/2008