Provider First Line Business Practice Location Address:
44216 N. 10TH W
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:
93534-4134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-273-8813
Provider Business Practice Location Address Fax Number:
661-273-2105
Provider Enumeration Date:
06/15/2006