Provider First Line Business Practice Location Address:
2320 WOOLSEY ST STE 111
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94705-1974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-849-0327
Provider Business Practice Location Address Fax Number:
510-849-4072
Provider Enumeration Date:
01/08/2007