Provider First Line Business Practice Location Address:
233 S VERDUGO RD UNIT A
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:
91205-1458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-822-0006
Provider Business Practice Location Address Fax Number:
818-822-0006
Provider Enumeration Date:
05/02/2024