Provider First Line Business Practice Location Address:
5530 ACKERFIELD AVE UNIT 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90805-4901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-225-9306
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2020