Provider First Line Business Practice Location Address:
1178 LIVE OAK BLVD
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:
95991-3407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-701-8466
Provider Business Practice Location Address Fax Number:
530-329-8598
Provider Enumeration Date:
07/18/2017