Provider First Line Business Practice Location Address:
367 DEL NORTE AVE
Provider Second Line Business Practice Location Address:
SUITE 4
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-751-9604
Provider Business Practice Location Address Fax Number:
530-751-9531
Provider Enumeration Date:
11/15/2006