Provider First Line Business Practice Location Address:
640 MARKET STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUSA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95932-2441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-458-2188
Provider Business Practice Location Address Fax Number:
530-458-7780
Provider Enumeration Date:
09/21/2006