Provider First Line Business Practice Location Address:
236 W EAST AVE STE H
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:
95926-7239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-342-6065
Provider Business Practice Location Address Fax Number:
530-343-7769
Provider Enumeration Date:
09/07/2011