Provider First Line Business Practice Location Address:
1221 W WHITTIER BLVD
Provider Second Line Business Practice Location Address:
MUSD COMMUNITY CENTER
Provider Business Practice Location Address City Name:
MONTEBELLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90640-4642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-887-2111
Provider Business Practice Location Address Fax Number:
323-887-2113
Provider Enumeration Date:
04/24/2007