Provider First Line Business Practice Location Address:
1225 B STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCATA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-822-5105
Provider Business Practice Location Address Fax Number:
707-822-2570
Provider Enumeration Date:
04/17/2008