Provider First Line Business Practice Location Address:
315 W WASHINGTON AVE
Provider Second Line Business Practice Location Address:
RITE-AID #5629
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-746-2263
Provider Business Practice Location Address Fax Number:
760-746-0549
Provider Enumeration Date:
04/02/2007