Provider First Line Business Practice Location Address:
5977 E SPRING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90808-3752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-421-3727
Provider Business Practice Location Address Fax Number:
562-420-8948
Provider Enumeration Date:
12/23/2008