Provider First Line Business Practice Location Address:
26020 COMPTCHE-UKIAH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COMPTCHE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95427
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-727-1907
Provider Business Practice Location Address Fax Number:
541-256-3772
Provider Enumeration Date:
04/09/2009