Provider First Line Business Practice Location Address:
2049 SKYLINE DR. LEMON GROVE CA, 91945
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMON GROVE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91945
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-466-9274
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2019