Provider First Line Business Practice Location Address:
6055 EAST WASHINGTON BLVD
Provider Second Line Business Practice Location Address:
900
Provider Business Practice Location Address City Name:
CITY OF COMPTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-346-0960
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2007