Provider First Line Business Practice Location Address:
2001 S BARRINGTON AVE
Provider Second Line Business Practice Location Address:
#116
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-5363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-728-6193
Provider Business Practice Location Address Fax Number:
413-403-4078
Provider Enumeration Date:
01/18/2006