Provider First Line Business Practice Location Address:
2410 K ST
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95816-5033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-444-4446
Provider Business Practice Location Address Fax Number:
916-444-4414
Provider Enumeration Date:
02/26/2007