Provider First Line Business Practice Location Address:
2800 SNOWDEN AVE
Provider Second Line Business Practice Location Address:
MILLIKAN HS LBUSD
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90815-1436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-425-7441
Provider Business Practice Location Address Fax Number:
562-425-1151
Provider Enumeration Date:
04/24/2007