Provider First Line Business Practice Location Address:
1906 FORT JONES RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YREKA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96097-9530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-622-3101
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2025