Provider First Line Business Practice Location Address:
1600 HUMBOLDT RD
Provider Second Line Business Practice Location Address:
ST 4
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-8100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-899-3935
Provider Business Practice Location Address Fax Number:
530-342-1383
Provider Enumeration Date:
01/12/2007