Provider First Line Business Practice Location Address:
2330 W COVELL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95616-5658
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-668-2600
Provider Business Practice Location Address Fax Number:
530-406-2897
Provider Enumeration Date:
08/08/2008