Provider First Line Business Practice Location Address:
UNITED STATES NAVY RESERVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMERON PARK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95682
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-672-9523
Provider Business Practice Location Address Fax Number:
530-672-0952
Provider Enumeration Date:
06/27/2005