Provider First Line Business Practice Location Address:
1550 MYERS ST
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95965-4689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-533-6604
Provider Business Practice Location Address Fax Number:
530-533-6568
Provider Enumeration Date:
08/18/2006