Provider First Line Business Practice Location Address:
1147 E AVENUE K12
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93535-2943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-526-4332
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/03/2016