Provider First Line Business Practice Location Address:
19366 SOLEDAD CANYON ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA CLARITA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91351-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-252-8888
Provider Business Practice Location Address Fax Number:
661-252-8808
Provider Enumeration Date:
11/17/2006