Provider First Line Business Practice Location Address:
360 E 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-5631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-561-4579
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2025