Provider First Line Business Practice Location Address:
412 8TH ST
Provider Second Line Business Practice Location Address:
B
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94607-3983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-452-4690
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006