Provider First Line Business Practice Location Address:
76 BROOKWOOD AVE
Provider Second Line Business Practice Location Address:
SANTA ROSA AMBULATORY SURGERY CENTER
Provider Business Practice Location Address City Name:
SANTA ROSA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-970-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2006