Provider First Line Business Practice Location Address:
480 E. 13TH ST.
Provider Second Line Business Practice Location Address:
BUILDING 2
Provider Business Practice Location Address City Name:
MERCED
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-381-6800
Provider Business Practice Location Address Fax Number:
209-725-3883
Provider Enumeration Date:
11/18/2010