Provider First Line Business Practice Location Address:
2545 CEANOTHUS AVE
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95973-7611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-342-2567
Provider Business Practice Location Address Fax Number:
530-342-2573
Provider Enumeration Date:
12/30/2006