Provider First Line Business Practice Location Address:
400 W 1ST ST
Provider Second Line Business Practice Location Address:
ACKER 149
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95929-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-898-5873
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2006