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Contractor

NPI: 1164808622Organization

Specialties, Licenses & Credentials

Point of Service

Code: 305S00000X

ContractorPrimary

Contractor

Code: 171W00000X

Contact & Hours

Address
206 FRANKLIN AVE
FORTUNA, CA 95540

Quick Facts

NPI
1164808622
Entity Type
Organization
Medicare
Not confirmed
Specialties
2
Locations
1

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