Provider First Line Business Practice Location Address:
1515 S OREGON ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
YREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-842-3955
Provider Business Practice Location Address Fax Number:
530-842-7917
Provider Enumeration Date:
05/03/2007