Provider First Line Business Practice Location Address:
120 E LONGDEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCADIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91006-5242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-481-0022
Provider Business Practice Location Address Fax Number:
213-357-5408
Provider Enumeration Date:
10/14/2010