Provider First Line Business Practice Location Address:
263 STANFORD CT
Provider Second Line Business Practice Location Address:
PACIFIC ORTHOPEDIC REHABILITATION CENTER
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-387-1699
Provider Business Practice Location Address Fax Number:
949-387-1699
Provider Enumeration Date:
11/02/2007