Provider First Line Business Practice Location Address:
31625 HIGHWAY 101 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOLEDAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93960-9529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-678-5500
Provider Business Practice Location Address Fax Number:
831-678-5660
Provider Enumeration Date:
12/03/2008