Provider First Line Business Practice Location Address:
900 MONO WAY
Provider Second Line Business Practice Location Address:
SPORTS MEDICINE AND REHABILITATION
Provider Business Practice Location Address City Name:
SONORA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-536-6920
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2015