Provider First Line Business Practice Location Address:
610 W 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DORRIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96023-9100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-397-8411
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/27/2020