Provider First Line Business Practice Location Address:
1275 THARP RD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95993-2640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-671-2034
Provider Business Practice Location Address Fax Number:
530-671-8394
Provider Enumeration Date:
10/20/2006