Provider First Line Business Practice Location Address:
25061 N PEACHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWHALL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-255-7530
Provider Business Practice Location Address Fax Number:
661-254-4798
Provider Enumeration Date:
08/22/2006