Provider First Line Business Practice Location Address:
671 S MOLLISON AVE
Provider Second Line Business Practice Location Address:
SUITE B & C
Provider Business Practice Location Address City Name:
EL CAJON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-841-8148
Provider Business Practice Location Address Fax Number:
844-350-9978
Provider Enumeration Date:
05/20/2006