Provider First Line Business Practice Location Address:
8676 LINDLEY AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91325-3318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-700-0000
Provider Business Practice Location Address Fax Number:
818-700-0030
Provider Enumeration Date:
11/07/2008