Provider First Line Business Practice Location Address:
1254 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603-5015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-889-9195
Provider Business Practice Location Address Fax Number:
530-889-9197
Provider Enumeration Date:
03/29/2007