Provider First Line Business Practice Location Address:
2320 WOOLSEY ST STE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94705-1974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-845-1505
Provider Business Practice Location Address Fax Number:
510-845-0923
Provider Enumeration Date:
01/22/2007