Provider First Line Business Practice Location Address:
1162 LIVE OAK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95991-3407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-743-5428
Provider Business Practice Location Address Fax Number:
530-743-6091
Provider Enumeration Date:
07/14/2009