Provider First Line Business Practice Location Address:
1211 MARICOPA HWY
Provider Second Line Business Practice Location Address:
SUITE 231
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023-3162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-646-2527
Provider Business Practice Location Address Fax Number:
805-640-8839
Provider Enumeration Date:
07/24/2006