Provider First Line Business Practice Location Address:
1017 10 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:
95521-6116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-822-3584
Provider Business Practice Location Address Fax Number:
707-822-3374
Provider Enumeration Date:
11/20/2006