Provider First Line Business Practice Location Address:
475 BRUCE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96097-3450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-842-1267
Provider Business Practice Location Address Fax Number:
530-842-9121
Provider Enumeration Date:
11/16/2005