Provider First Line Business Practice Location Address:
411 SOUTH LONG BEACH BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COMPTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-608-2353
Provider Business Practice Location Address Fax Number:
310-943-3384
Provider Enumeration Date:
12/11/2006