Provider First Line Business Practice Location Address:
655 F ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCATA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95521-6325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-822-2224
Provider Business Practice Location Address Fax Number:
707-822-2225
Provider Enumeration Date:
08/25/2016