Provider First Line Business Practice Location Address:
483 GRASS VALLEY HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603-3713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-537-2250
Provider Business Practice Location Address Fax Number:
530-537-2263
Provider Enumeration Date:
06/27/2025