Provider First Line Business Practice Location Address:
185 E 7TH AVE STE C
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95926-3356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-893-4393
Provider Business Practice Location Address Fax Number:
530-893-1543
Provider Enumeration Date:
11/16/2006