Provider First Line Business Practice Location Address:
1074 EAST AVE STE J
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:
95926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-895-3434
Provider Business Practice Location Address Fax Number:
530-895-3616
Provider Enumeration Date:
12/06/2006