Provider First Line Business Practice Location Address:
251 E AVENUE K6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93535-4509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-738-4601
Provider Business Practice Location Address Fax Number:
213-652-1983
Provider Enumeration Date:
08/02/2006