Provider First Line Business Practice Location Address:
915 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95825-6725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-925-4700
Provider Business Practice Location Address Fax Number:
916-451-5355
Provider Enumeration Date:
04/20/2007