Provider First Line Business Practice Location Address:
1378 LONGFELLOW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95926-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-895-3923
Provider Business Practice Location Address Fax Number:
530-895-0172
Provider Enumeration Date:
08/05/2006