Provider First Line Business Practice Location Address:
2503 K ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95816-5101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-448-4500
Provider Business Practice Location Address Fax Number:
916-448-2322
Provider Enumeration Date:
01/24/2007