Provider First Line Business Practice Location Address:
PROGRESS HOUSE PERINATAL FACILITY
Provider Second Line Business Practice Location Address:
5494 PONY EXPRESS TRAIL
Provider Business Practice Location Address City Name:
CAMINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-644-3758
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/20/2007