Provider First Line Business Practice Location Address:
235 SPRUCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRIDLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-846-2697
Provider Business Practice Location Address Fax Number:
530-846-6426
Provider Enumeration Date:
02/08/2006