Provider First Line Business Practice Location Address:
701 HIGH STREET
Provider Second Line Business Practice Location Address:
SUITE 228
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-401-3537
Provider Business Practice Location Address Fax Number:
916-649-7158
Provider Enumeration Date:
04/11/2013