Provider First Line Business Practice Location Address:
1300 W 7TH ST
Provider Second Line Business Practice Location Address:
PROVIDENCE LITTLE COMPANY SAN PEDRO HOSPITAL REHAB
Provider Business Practice Location Address City Name:
SAN PEDRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90732-3505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-386-2305
Provider Business Practice Location Address Fax Number:
310-540-4640
Provider Enumeration Date:
10/26/2009