Provider First Line Business Practice Location Address:
145 W. MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95695-2914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-661-6100
Provider Business Practice Location Address Fax Number:
530-661-2283
Provider Enumeration Date:
06/14/2007