Provider First Line Business Practice Location Address:
615 W 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:
95926-7201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-487-8114
Provider Business Practice Location Address Fax Number:
530-592-3492
Provider Enumeration Date:
04/08/2020