Provider First Line Business Practice Location Address:
1320 MARICOPA HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE I
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023-3154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-646-8138
Provider Business Practice Location Address Fax Number:
805-646-3150
Provider Enumeration Date:
10/20/2006