Provider First Line Business Practice Location Address:
7542 LAUREL CANYON BLVD
Provider Second Line Business Practice Location Address:
7540 LAUREL CANYON BLVD.
Provider Business Practice Location Address City Name:
NORTH HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91605-3148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-765-0503
Provider Business Practice Location Address Fax Number:
818-765-5908
Provider Enumeration Date:
04/25/2007