Provider First Line Business Practice Location Address:
1408 LIVE OAK BLVD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-2970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-742-0388
Provider Business Practice Location Address Fax Number:
530-742-0736
Provider Enumeration Date:
07/17/2006