Provider First Line Business Practice Location Address:
1200 MARICOPA HWY
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023-3129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-640-0180
Provider Business Practice Location Address Fax Number:
805-640-0181
Provider Enumeration Date:
04/17/2007