Provider First Line Business Practice Location Address:
28420 HASKELL 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:
91390
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-513-9595
Provider Business Practice Location Address Fax Number:
661-513-9119
Provider Enumeration Date:
04/25/2008