Provider First Line Business Practice Location Address:
1609 EAST MADISON AVE
Provider Second Line Business Practice Location Address:
EL CAJON MEDICAL THERAPY UNIT
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92019-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-588-3169
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2007