Provider First Line Business Practice Location Address:
2800 LINCOLN STREET
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-282-4146
Provider Business Practice Location Address Fax Number:
530-282-4359
Provider Enumeration Date:
12/01/2014