Provider First Line Business Practice Location Address:
247 MARCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA PAULA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93060-2511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-933-6622
Provider Business Practice Location Address Fax Number:
806-933-6629
Provider Enumeration Date:
07/22/2006