Provider First Line Business Practice Location Address:
1560 HUMBOLDT RD
Provider Second Line Business Practice Location Address:
#5
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-891-6331
Provider Business Practice Location Address Fax Number:
630-891-6200
Provider Enumeration Date:
12/18/2006