Provider First Line Business Practice Location Address:
2962 JEFFERSON AVE
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:
95993-8824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-674-1129
Provider Business Practice Location Address Fax Number:
530-674-1506
Provider Enumeration Date:
01/18/2008