Provider First Line Business Practice Location Address:
1263 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603-5016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-888-1825
Provider Business Practice Location Address Fax Number:
530-888-1842
Provider Enumeration Date:
10/26/2006