Provider First Line Business Practice Location Address:
2771 E FLORENCE 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:
90255-5750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-582-1414
Provider Business Practice Location Address Fax Number:
323-582-4610
Provider Enumeration Date:
05/03/2007