Provider First Line Business Practice Location Address:
1128 YUBA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARYSVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95901-4831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-538-8221
Provider Business Practice Location Address Fax Number:
530-534-7850
Provider Enumeration Date:
02/04/2014