Provider First Line Business Practice Location Address:
5385 FRANKLIN BLVD STE K
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:
95820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-428-0656
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2008