Provider First Line Business Practice Location Address:
6512 LAUREL CANYON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH HOLLYWOOD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91606-1521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-623-9000
Provider Business Practice Location Address Fax Number:
818-623-9007
Provider Enumeration Date:
02/07/2007