Provider First Line Business Practice Location Address:
529 I ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-629-2410
Provider Business Practice Location Address Fax Number:
530-629-4306
Provider Enumeration Date:
09/29/2010