Provider First Line Business Practice Location Address:
610 WEST 3RD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DORRIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-397-8411
Provider Business Practice Location Address Fax Number:
530-397-4567
Provider Enumeration Date:
01/05/2010