Provider First Line Business Practice Location Address:
1660 HUMBOLDT RD
Provider Second Line Business Practice Location Address:
STE. 3
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-9199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-345-2966
Provider Business Practice Location Address Fax Number:
530-877-0640
Provider Enumeration Date:
07/12/2006