Provider First Line Business Practice Location Address:
18TH AVENUE AND HIGHWAY 53
Provider Second Line Business Practice Location Address:
EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
CLEARLAKE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95422-6720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-994-6486
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2006