Provider First Line Business Practice Location Address:
MOB2 MEDICAL OFFICES
Provider Second Line Business Practice Location Address:
4531 DALE ROAD, 3RD FLOOR, #342
Provider Business Practice Location Address City Name:
MODESTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-735-6818
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2007