Provider First Line Business Practice Location Address:
2545 CEANOTHUS AVE
Provider Second Line Business Practice Location Address:
SUITE #134
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95973-7717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-342-5653
Provider Business Practice Location Address Fax Number:
530-342-8023
Provider Enumeration Date:
11/08/2006