Provider First Line Business Practice Location Address:
1321 SPRUCE ST
Provider Second Line Business Practice Location Address:
#3
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94709-1499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-548-3294
Provider Business Practice Location Address Fax Number:
510-548-3294
Provider Enumeration Date:
01/02/2007