Provider First Line Business Practice Location Address:
1005 KIMBALL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-4334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-978-4422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2025