Provider First Line Business Practice Location Address:
120A W COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95695-2901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-668-6000
Provider Business Practice Location Address Fax Number:
530-668-9560
Provider Enumeration Date:
07/09/2006