Provider First Line Business Practice Location Address:
2550 KENWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93536-1126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-208-8905
Provider Business Practice Location Address Fax Number:
661-466-1827
Provider Enumeration Date:
09/26/2018