Provider First Line Business Practice Location Address:
333 S AUBURN ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
COLFAX
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95713-9778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-346-2269
Provider Business Practice Location Address Fax Number:
530-346-2593
Provider Enumeration Date:
12/14/2016