Provider First Line Business Practice Location Address:
848 WEST LANCASTER BLVD.
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-948-6168
Provider Business Practice Location Address Fax Number:
661-533-1323
Provider Enumeration Date:
10/03/2006