Provider First Line Business Practice Location Address:
1007 LIVE OAK BLVD
Provider Second Line Business Practice Location Address:
SUITE B2
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-3454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-713-5828
Provider Business Practice Location Address Fax Number:
530-674-2744
Provider Enumeration Date:
11/15/2006