Provider First Line Business Practice Location Address:
229 CLARK AVE STE P
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:
95991-5363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-760-8333
Provider Business Practice Location Address Fax Number:
530-923-7937
Provider Enumeration Date:
05/20/2019