Provider First Line Business Practice Location Address:
7885 HIGHWAY 99 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS MOLINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-384-2330
Provider Business Practice Location Address Fax Number:
530-384-2583
Provider Enumeration Date:
02/21/2007