Provider First Line Business Practice Location Address:
CLINIC #9823
Provider Second Line Business Practice Location Address:
1350 FLORIN RD
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95822-4202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-392-5184
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2021