Provider First Line Business Practice Location Address:
1215 LINCOLN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95965-4810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-854-4959
Provider Business Practice Location Address Fax Number:
530-854-4902
Provider Enumeration Date:
08/22/2018