Provider First Line Business Practice Location Address:
1711 W LEEWOOD STREET
Provider Second Line Business Practice Location Address:
IN HOME SERVICES HOUSECALLS
Provider Business Practice Location Address City Name:
WEST COVINA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91790-2604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-229-1941
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/10/2007