Provider First Line Business Practice Location Address:
1133 HIGH ST
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603-5152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-852-5066
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006