Provider First Line Business Practice Location Address:
1496 EAST AVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-869-5404
Provider Business Practice Location Address Fax Number:
530-896-1174
Provider Enumeration Date:
10/09/2007