Provider First Line Business Practice Location Address:
2486 PONDEROSA NORTH
Provider Second Line Business Practice Location Address:
SUITE D 106 DOS CAMINOS PHYSICAL THERAPY AND SPORTS REH
Provider Business Practice Location Address City Name:
CAMARILLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93010-2376
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-484-5447
Provider Business Practice Location Address Fax Number:
805-484-2158
Provider Enumeration Date:
02/01/2008