Provider First Line Business Practice Location Address: 
11716 ENTERPRISE DR
    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: 
95603-3732
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
530-886-2880
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
04/11/2007