Provider First Line Business Practice Location Address:
600 F STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-601-6434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2007