Provider First Line Business Practice Location Address:
101 N. LA BREA AVE, STE 201
Provider Second Line Business Practice Location Address:
INGLEWOOD PAROLE CLINICS 4 & 6
Provider Business Practice Location Address City Name:
INGLEWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90301-1769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-412-6134
Provider Business Practice Location Address Fax Number:
310-412-6355
Provider Enumeration Date:
07/25/2008