Provider First Line Business Practice Location Address:
120 WHITCOMB AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLFAX
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-346-6244
Provider Business Practice Location Address Fax Number:
530-346-6001
Provider Enumeration Date:
02/03/2006