Provider First Line Business Practice Location Address:
1202 MARICOPA HWY
Provider Second Line Business Practice Location Address:
STE E
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023-3169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-646-1777
Provider Business Practice Location Address Fax Number:
805-646-8871
Provider Enumeration Date:
04/10/2007