Provider First Line Business Practice Location Address:
11720 EDUCATION ST
Provider Second Line Business Practice Location Address:
STE 2
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:
530-823-2523
Provider Business Practice Location Address Fax Number:
530-823-2526
Provider Enumeration Date:
08/31/2006