Provider First Line Business Practice Location Address:
2526 WEBSTER ST
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:
94705-2550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-734-6559
Provider Business Practice Location Address Fax Number:
510-526-4092
Provider Enumeration Date:
07/06/2007