Provider First Line Business Practice Location Address:
223 NORTH FIRST AVE.
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
ARCADIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-821-4880
Provider Business Practice Location Address Fax Number:
626-821-4477
Provider Enumeration Date:
10/07/2005