Provider First Line Business Practice Location Address:
770 11TH STREET
Provider Second Line Business Practice Location Address:
LOST COAST HEALING ARTS
Provider Business Practice Location Address City Name:
ARCATA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-633-4991
Provider Business Practice Location Address Fax Number:
224-365-3981
Provider Enumeration Date:
01/16/2009