Provider First Line Business Practice Location Address:
1060 UNIVERSITY AVE STE A215
Provider Second Line Business Practice Location Address:
MIRACLE-EAR CENTER
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92103-7345
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-574-9900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2011