Provider First Line Business Practice Location Address:
1212 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603-5015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-889-1476
Provider Business Practice Location Address Fax Number:
530-823-8387
Provider Enumeration Date:
03/13/2007