Provider First Line Business Practice Location Address:
C/O UCSC STUDENT HEALTH SERVICES
Provider Second Line Business Practice Location Address:
1156 HIGH ST
Provider Business Practice Location Address City Name:
SANTA CRUZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-466-7869
Provider Business Practice Location Address Fax Number:
208-466-5359
Provider Enumeration Date:
03/23/2006