Provider First Line Business Practice Location Address:
236 W 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-5311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-342-8314
Provider Business Practice Location Address Fax Number:
530-342-8362
Provider Enumeration Date:
03/07/2012