Provider First Line Business Practice Location Address:
2675 SATURN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90255-4142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-581-0117
Provider Business Practice Location Address Fax Number:
323-562-4445
Provider Enumeration Date:
03/22/2007