Provider First Line Business Practice Location Address:
3712 S BARRINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90066-3210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-252-8074
Provider Business Practice Location Address Fax Number:
646-568-7604
Provider Enumeration Date:
04/21/2010