Provider First Line Business Practice Location Address:
12087 LOPEZ CANYON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYLMAR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91342-6063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-639-7070
Provider Business Practice Location Address Fax Number:
818-639-7080
Provider Enumeration Date:
04/10/2020