Provider First Line Business Practice Location Address:
2092 LIVE OAK BLVD
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:
95991-8828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-674-9440
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2005