Provider First Line Business Practice Location Address:
2858 OLIVE HIGHWAY
Provider Second Line Business Practice Location Address:
SUITES A B & C
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-538-2158
Provider Business Practice Location Address Fax Number:
530-533-7188
Provider Enumeration Date:
12/12/2006