Provider First Line Business Practice Location Address:
5805 HIGH SCHOOL WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNSMUIR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96025-2299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-235-4835
Provider Business Practice Location Address Fax Number:
530-235-2224
Provider Enumeration Date:
02/06/2025