Provider First Line Business Practice Location Address:
11716 ENTERPRISE DRIVE
Provider Second Line Business Practice Location Address:
PLACER COUNTY CSOC
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-886-2811
Provider Business Practice Location Address Fax Number:
530-889-6735
Provider Enumeration Date:
03/27/2007