Provider First Line Business Practice Location Address:
8648 YUBA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SODA SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-426-1336
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2007