Provider First Line Business Practice Location Address:
ONE SHIELDS AVE
Provider Second Line Business Practice Location Address:
219 NORTH HALL CAPS UC DAVIS
Provider Business Practice Location Address City Name:
DAVIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95616-5270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-752-0871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2008