Provider First Line Business Practice Location Address:
1007 LIVE OAK BLVD
Provider Second Line Business Practice Location Address:
STE A-1
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-3454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-673-3790
Provider Business Practice Location Address Fax Number:
530-673-5642
Provider Enumeration Date:
12/07/2006