Provider First Line Business Practice Location Address:
744 1/2 N GLENDALE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-246-8444
Provider Business Practice Location Address Fax Number:
818-246-0669
Provider Enumeration Date:
09/08/2006