Provider First Line Business Practice Location Address:
3816 WOODRUFF AVE STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90808-2145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-496-2340
Provider Business Practice Location Address Fax Number:
562-627-0902
Provider Enumeration Date:
09/27/2006