Provider First Line Business Practice Location Address:
270 COUNTY HOSPITAL RD
Provider Second Line Business Practice Location Address:
#109
Provider Business Practice Location Address City Name:
QUINCY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95971-9126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-283-6307
Provider Business Practice Location Address Fax Number:
530-283-6045
Provider Enumeration Date:
10/25/2006