Provider First Line Business Practice Location Address:
1190 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-3451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-713-4305
Provider Business Practice Location Address Fax Number:
530-674-5994
Provider Enumeration Date:
05/14/2008