Provider First Line Business Practice Location Address:
3380 AVALON
Provider Second Line Business Practice Location Address:
YUCCA MESA MTU
Provider Business Practice Location Address City Name:
YUCCA VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92286-0042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-369-6315
Provider Business Practice Location Address Fax Number:
760-369-1237
Provider Enumeration Date:
11/01/2006