Provider First Line Business Practice Location Address:
1525 BRIDGE ST
Provider Second Line Business Practice Location Address:
APT 94
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95993-8600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-415-6499
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/11/2014