Provider First Line Business Practice Location Address:
479 ORO DAM BLVD EAST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95965-5714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-534-9500
Provider Business Practice Location Address Fax Number:
530-534-0536
Provider Enumeration Date:
01/26/2007