Provider First Line Business Practice Location Address:
1137 W. 6TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOAS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-250-1005
Provider Business Practice Location Address Fax Number:
213-250-1006
Provider Enumeration Date:
05/11/2007