Provider First Line Business Practice Location Address:
1600 SACRAMENTO INN WAY STE 217
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95815-3461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-414-8833
Provider Business Practice Location Address Fax Number:
916-414-8696
Provider Enumeration Date:
06/27/2026