Provider First Line Business Practice Location Address:
12700 CENTERVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95928-8328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-455-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2011