Provider First Line Business Practice Location Address:
340 E 8TH ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
NATIONAL CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91950-2359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-477-7770
Provider Business Practice Location Address Fax Number:
619-477-7775
Provider Enumeration Date:
01/03/2008