Provider First Line Business Practice Location Address:
1121 S 4TH ST
Provider Second Line Business Practice Location Address:
SUITE A - EL CENTRO ACUPUNCTURE
Provider Business Practice Location Address City Name:
EL CENTRO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92243-4742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-370-0516
Provider Business Practice Location Address Fax Number:
760-370-0516
Provider Enumeration Date:
05/12/2006