Provider First Line Business Practice Location Address:
11795 EDUCATION STREET
Provider Second Line Business Practice Location Address:
SUITE 222
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95602-2469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-886-6660
Provider Business Practice Location Address Fax Number:
530-886-6656
Provider Enumeration Date:
09/12/2005