Provider First Line Business Practice Location Address:
725 E SANTA PAULA ST
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
SANTA PAULA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93060-2066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-933-8480
Provider Business Practice Location Address Fax Number:
805-933-2641
Provider Enumeration Date:
07/18/2016