Provider First Line Business Practice Location Address:
1359 E. LASSE AVE.
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:
95973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
230-230-9230
Provider Business Practice Location Address Fax Number:
530-466-3154
Provider Enumeration Date:
02/25/2026