Provider First Line Business Practice Location Address:
2712 TELEGRAPH AVENUE
Provider Second Line Business Practice Location Address:
PACIFIC CENTER FOR HUMAN GROWTH
Provider Business Practice Location Address City Name:
BERKELEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-548-8283
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2012