Provider First Line Business Practice Location Address:
1600 W 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93030-6520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-981-4200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2007