Provider First Line Business Practice Location Address:
1202 MARICOPA HWY STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OJAI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93023-3170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-640-0068
Provider Business Practice Location Address Fax Number:
805-640-1749
Provider Enumeration Date:
12/10/2014