Provider First Line Business Practice Location Address:
2320 WOOLSEY ST STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-848-7533
Provider Business Practice Location Address Fax Number:
510-848-0105
Provider Enumeration Date:
06/15/2006