Provider First Line Business Practice Location Address:
129 S WASHINGTON ST
Provider Second Line Business Practice Location Address:
WASHINGTON SCHOOL
Provider Business Practice Location Address City Name:
CLOVERDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-894-1940
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2025