Provider First Line Business Practice Location Address:
426 W. 5TH STREET
Provider Second Line Business Practice Location Address:
OXNARD CLUBHOUSE
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-247-0750
Provider Business Practice Location Address Fax Number:
805-247-0754
Provider Enumeration Date:
06/07/2013