Provider First Line Business Practice Location Address:
555 SALEM ST
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:
95928-5536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-895-3732
Provider Business Practice Location Address Fax Number:
530-895-0905
Provider Enumeration Date:
10/18/2006