Provider First Line Business Practice Location Address:
202 LAWRENCE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96097-3341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-572-1566
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2013