Provider First Line Business Practice Location Address:
2293 RIVER OAKS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLUMAS LAKE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95961-9194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-634-9980
Provider Business Practice Location Address Fax Number:
530-634-9986
Provider Enumeration Date:
03/11/2009