Provider First Line Business Practice Location Address:
239 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:
95695-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-668-2656
Provider Business Practice Location Address Fax Number:
530-662-4527
Provider Enumeration Date:
07/14/2006