Provider First Line Business Practice Location Address:
550 RUSS ST
Provider Second Line Business Practice Location Address:
ANA C KING II MEMORIAL BLDG
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:
707-441-1898
Provider Business Practice Location Address Fax Number:
707-441-1945
Provider Enumeration Date:
02/13/2006