Provider First Line Business Practice Location Address:
21726 PLACERITA CANYON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91321-1235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-362-2760
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/17/2020