Provider First Line Business Practice Location Address:
1000 NORTHRIDGE FASHION CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHRIDGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-885-1938
Provider Business Practice Location Address Fax Number:
818-885-0132
Provider Enumeration Date:
08/04/2009