Provider First Line Business Practice Location Address:
2445 ORO DAM BLVD E
Provider Second Line Business Practice Location Address:
SUITE 9
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95966-6035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-532-9555
Provider Business Practice Location Address Fax Number:
530-532-1436
Provider Enumeration Date:
10/21/2012