Provider First Line Business Practice Location Address:
1133 GRAY AVE STE B
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:
95991-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-329-9339
Provider Business Practice Location Address Fax Number:
530-673-1955
Provider Enumeration Date:
03/15/2013