Provider First Line Business Practice Location Address:
2216 FAIR 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:
95928-6748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-491-0204
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2026