Provider First Line Business Practice Location Address:
200 SOUTH A STREET
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-486-1356
Provider Business Practice Location Address Fax Number:
805-486-8206
Provider Enumeration Date:
03/20/2007