Provider First Line Business Practice Location Address:
DEBRA ANN MOTZ
Provider Second Line Business Practice Location Address:
265 COVINA AVE, APT B
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-438-3365
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2006