Provider First Line Business Practice Location Address:
241 W COMPTON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COMPTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90220-3108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-764-2555
Provider Business Practice Location Address Fax Number:
310-764-0091
Provider Enumeration Date:
09/28/2007