Provider First Line Business Practice Location Address:
7601 EAST IMPERIAL BLVD.
Provider Second Line Business Practice Location Address:
RANCHO LOS AMIGOS JPI 3RD FLOOR NEUROREHAB OFFICE
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-401-7713
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2007