Provider First Line Business Practice Location Address:
1560 HUMBOLDT RD STE 2
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:
95928-9101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-592-4334
Provider Business Practice Location Address Fax Number:
530-592-4335
Provider Enumeration Date:
07/15/2021