Provider First Line Business Practice Location Address:
2821 TELEGRAPH 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:
94705-1118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-848-4430
Provider Business Practice Location Address Fax Number:
510-845-3834
Provider Enumeration Date:
03/09/2007