Provider First Line Business Practice Location Address:
44459 & 44461 10TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-996-1051
Provider Business Practice Location Address Fax Number:
818-996-3051
Provider Enumeration Date:
04/22/2011