Provider First Line Business Practice Location Address:
1414 LA GRANDE AVE
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:
95991-6516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-673-9373
Provider Business Practice Location Address Fax Number:
530-673-9374
Provider Enumeration Date:
11/28/2006