Provider First Line Business Practice Location Address:
11720 EDUCATION ST STE 5
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:
95602-2419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-885-9191
Provider Business Practice Location Address Fax Number:
530-823-9119
Provider Enumeration Date:
07/17/2006