Provider First Line Business Practice Location Address:
242 W 12TH AVE
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:
95926-2129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-588-5027
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2026