Provider First Line Business Practice Location Address:
311 H ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCATA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95521-6636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
980-474-8474
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2023