Provider First Line Business Practice Location Address:
195 PERRY PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94610-2929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-444-0583
Provider Business Practice Location Address Fax Number:
510-444-6040
Provider Enumeration Date:
04/02/2007