Provider First Line Business Practice Location Address:
ORTHOPEDICS; ADVENTIST HEALTH
Provider Second Line Business Practice Location Address:
1235 W VINE ST #22
Provider Business Practice Location Address City Name:
LODI
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-334-8520
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/25/2019