Provider First Line Business Practice Location Address:
1100 W ARTESIA 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:
90220-5108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-522-0550
Provider Business Practice Location Address Fax Number:
310-884-2908
Provider Enumeration Date:
02/04/2014