Provider First Line Business Practice Location Address:
8244 EAST 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-923-4543
Provider Business Practice Location Address Fax Number:
562-923-5103
Provider Enumeration Date:
09/25/2006