Provider First Line Business Practice Location Address:
770 10TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCATA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-826-8610
Provider Business Practice Location Address Fax Number:
707-826-8623
Provider Enumeration Date:
10/03/2006