Provider First Line Business Practice Location Address:
3202 E. FLORENCE AVENUE
Provider Second Line Business Practice Location Address:
N/A
Provider Business Practice Location Address City Name:
HUNTINGTON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90255-5800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-935-6310
Provider Business Practice Location Address Fax Number:
310-792-2321
Provider Enumeration Date:
10/03/2006