Provider First Line Business Practice Location Address:
441 COLUSA AVE
Provider Second Line Business Practice Location Address:
STE C
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:
530-671-4930
Provider Business Practice Location Address Fax Number:
530-671-0219
Provider Enumeration Date:
03/30/2006