Provider First Line Business Practice Location Address:
870 SHASTA ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-4152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-671-3671
Provider Business Practice Location Address Fax Number:
530-671-3980
Provider Enumeration Date:
11/16/2006