Provider First Line Business Practice Location Address:
1817 W. AVE. K
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93435-6421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-729-9700
Provider Business Practice Location Address Fax Number:
661-729-8650
Provider Enumeration Date:
11/26/2007