Provider First Line Business Practice Location Address:
241 W EAST AVE STE 1
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:
95926-7205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-332-8972
Provider Business Practice Location Address Fax Number:
530-338-3145
Provider Enumeration Date:
03/06/2019