Provider First Line Business Practice Location Address:
11860 KEMPER RD
Provider Second Line Business Practice Location Address:
# 4
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-823-7413
Provider Business Practice Location Address Fax Number:
530-823-6798
Provider Enumeration Date:
11/07/2005