Provider First Line Business Practice Location Address:
24035 NEWHALL RANCH 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:
91355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-792-4012
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/30/2016