Provider First Line Business Practice Location Address:
1638 HUNTOON ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95965-4909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-282-5383
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2026