Provider First Line Business Practice Location Address:
1624 STARR DR
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95993-2636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-692-0680
Provider Business Practice Location Address Fax Number:
530-692-0450
Provider Enumeration Date:
04/23/2007