Provider First Line Business Practice Location Address:
18144 SECO ST
Provider Second Line Business Practice Location Address:
MATHIESEN MEMORIAL HEALTH CLINIC
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95327-9737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-984-4824
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2007