Provider First Line Business Practice Location Address:
1 HIGH SCHOOL HILL RD
Provider Second Line Business Practice Location Address:
ROOMS A107,A121,A125,A167,A232
Provider Business Practice Location Address City Name:
ATASCADERO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93422-4189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-781-4753
Provider Business Practice Location Address Fax Number:
805-781-1227
Provider Enumeration Date:
03/25/2013