Provider First Line Business Practice Location Address:
1488 EAST AVE STE 130
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:
95926-1795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-342-1310
Provider Business Practice Location Address Fax Number:
530-342-1327
Provider Enumeration Date:
04/06/2006