Provider First Line Business Practice Location Address:
412 W CENTER ST
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:
96097-2810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-340-1836
Provider Business Practice Location Address Fax Number:
530-842-3467
Provider Enumeration Date:
07/23/2006