Provider First Line Business Practice Location Address:
UNIVERSITY OF CALIFORNIA RIVERSIDE
Provider Second Line Business Practice Location Address:
1207 SPROUL HALL
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92521-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-218-8536
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2017