Provider First Line Business Practice Location Address:
871 GRAY AVE.
Provider Second Line Business Practice Location Address:
SUITE B
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:
530-763-3222
Provider Business Practice Location Address Fax Number:
844-534-8464
Provider Enumeration Date:
09/13/2011