Provider First Line Business Practice Location Address:
139 MAGNOLIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-483-1166
Provider Business Practice Location Address Fax Number:
805-483-1145
Provider Enumeration Date:
06/28/2024