Provider First Line Business Practice Location Address:
930 SPRUCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94707-2425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-541-9024
Provider Business Practice Location Address Fax Number:
510-526-3342
Provider Enumeration Date:
06/16/2006