Provider First Line Business Practice Location Address:
1018 LIVE OAK BLVD STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-3450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-673-3755
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2008