Provider First Line Business Practice Location Address:
38427 20TH ST E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALMDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93550-4034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-273-3600
Provider Business Practice Location Address Fax Number:
661-273-3760
Provider Enumeration Date:
09/27/2007