Provider First Line Business Practice Location Address:
1350 E 9TH ST
Provider Second Line Business Practice Location Address:
SUITE 190
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-7395
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-456-1457
Provider Business Practice Location Address Fax Number:
530-230-3811
Provider Enumeration Date:
11/05/2009