Provider First Line Business Practice Location Address:
1429 COLUSA HWY STE B
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:
95993-9092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-755-3218
Provider Business Practice Location Address Fax Number:
530-755-3219
Provider Enumeration Date:
07/26/2006