Provider First Line Business Practice Location Address:
1279 E 1ST AVE
Provider Second Line Business Practice Location Address:
STE C
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95926-1542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-899-7300
Provider Business Practice Location Address Fax Number:
530-899-7211
Provider Enumeration Date:
06/16/2005