Provider First Line Business Practice Location Address:
22961 SOLEDAD CANYON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91350-2633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-200-3677
Provider Business Practice Location Address Fax Number:
661-388-4496
Provider Enumeration Date:
03/08/2007