Provider First Line Business Practice Location Address:
1408 LIVE OAK BLVD
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-671-3111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/27/2005