Provider First Line Business Practice Location Address:
2211 E. 7TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-439-6562
Provider Business Practice Location Address Fax Number:
562-434-7892
Provider Enumeration Date:
03/08/2007