Provider First Line Business Practice Location Address:
480 EAST 13TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95341-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-381-6800
Provider Business Practice Location Address Fax Number:
209-725-3883
Provider Enumeration Date:
02/07/2007