Provider First Line Business Practice Location Address:
1156 HIGH STREET
Provider Second Line Business Practice Location Address:
UC SANTA CRUZ - EAST FIELD HOUSE - OPERS
Provider Business Practice Location Address City Name:
SANTA CRUZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95064-1077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-459-4793
Provider Business Practice Location Address Fax Number:
831-459-4070
Provider Enumeration Date:
12/26/2017