Provider First Line Business Practice Location Address:
785 UNIVERSITY AVE
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:
95825-6708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-564-8888
Provider Business Practice Location Address Fax Number:
916-927-7032
Provider Enumeration Date:
11/28/2006