Provider First Line Business Practice Location Address:
325 S BROADWAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96097-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-842-1420
Provider Business Practice Location Address Fax Number:
530-842-7891
Provider Enumeration Date:
07/24/2007