Provider First Line Business Practice Location Address:
870 SHASTA ST
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-4117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-674-8032
Provider Business Practice Location Address Fax Number:
530-674-0602
Provider Enumeration Date:
10/05/2006