Provider First Line Business Practice Location Address:
1273 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96097-3433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-841-0503
Provider Business Practice Location Address Fax Number:
530-841-0413
Provider Enumeration Date:
10/26/2006