Provider First Line Business Practice Location Address:
2746 FLORENCE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-582-1780
Provider Business Practice Location Address Fax Number:
323-582-6271
Provider Enumeration Date:
12/11/2006