Provider First Line Business Practice Location Address:
800 SOUTH LOWER SACRAMENTO ROAD
Provider Second Line Business Practice Location Address:
LODI MEMORIAL HOSPITAL WEST
Provider Business Practice Location Address City Name:
LODI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-334-3311
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2007