Provider First Line Business Practice Location Address:
7901 FROST ST
Provider Second Line Business Practice Location Address:
ORTHO/NEURO SERVICE LINE
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123-2701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-939-3948
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2010