Provider First Line Business Practice Location Address:
CAL POLY HEALTH SERVICES
Provider Second Line Business Practice Location Address:
GRAND AVE.
Provider Business Practice Location Address City Name:
SAN LUIS OBISPO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-756-1211
Provider Business Practice Location Address Fax Number:
805-756-5298
Provider Enumeration Date:
12/13/2006