Provider First Line Business Practice Location Address:
2655 SHATTUCK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94704-3237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-486-8706
Provider Business Practice Location Address Fax Number:
510-849-1008
Provider Enumeration Date:
02/13/2006