Provider First Line Business Practice Location Address:
1910 CALIFORNIA ST
Provider Second Line Business Practice Location Address:
PACE HUMBOLDT RESOURCE CENTER
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-443-9747
Provider Business Practice Location Address Fax Number:
707-443-3204
Provider Enumeration Date:
09/14/2006