Provider First Line Business Practice Location Address:
550 SALEM ST
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:
95928-5575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-896-0701
Provider Business Practice Location Address Fax Number:
530-896-0701
Provider Enumeration Date:
01/08/2007