Provider First Line Business Practice Location Address:
121 W 16TH ST
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:
95928-6501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-897-2123
Provider Business Practice Location Address Fax Number:
530-897-2124
Provider Enumeration Date:
05/09/2013