Provider First Line Business Practice Location Address:
1352 COLUSA HWY STE C
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:
95993-9147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-618-8178
Provider Business Practice Location Address Fax Number:
530-618-8031
Provider Enumeration Date:
03/15/2006