Provider First Line Business Practice Location Address:
9709 STATE ROUTE 267 STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRUCKEE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96161-0369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-544-2111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2026