Provider First Line Business Practice Location Address:
11815 EDUCATION STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95602-2410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-886-6558
Provider Business Practice Location Address Fax Number:
530-889-6035
Provider Enumeration Date:
06/21/2007