Provider First Line Business Practice Location Address:
9745 LAUREL CANYON BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91331-4115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-869-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2020