Provider First Line Business Practice Location Address:
1408 LIVE OAK BLVD STE E
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:
95991-2970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-755-0571
Provider Business Practice Location Address Fax Number:
530-671-5173
Provider Enumeration Date:
09/25/2006