Provider First Line Business Practice Location Address:
120 W. MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-321-7679
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2011