Provider First Line Business Practice Location Address:
2421 E VALLEY PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESCONDIDO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92027-2932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-233-9655
Provider Business Practice Location Address Fax Number:
760-233-9648
Provider Enumeration Date:
05/08/2006