Provider First Line Business Practice Location Address:
2100 PEABODY ROAD
Provider Second Line Business Practice Location Address:
MEDICAL MODULAR
Provider Business Practice Location Address City Name:
VACAVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-454-3261
Provider Business Practice Location Address Fax Number:
707-454-3202
Provider Enumeration Date:
12/26/2006