Provider First Line Business Practice Location Address:
3138 ROOSEVELT ST STE K
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLSBAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92008-3022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-846-3588
Provider Business Practice Location Address Fax Number:
619-923-2918
Provider Enumeration Date:
03/14/2007