Provider First Line Business Practice Location Address:
1720 WEST AVENUE J
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534-2700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-940-6060
Provider Business Practice Location Address Fax Number:
661-940-9022
Provider Enumeration Date:
11/08/2006