Provider First Line Business Practice Location Address:
395 DEL NORTE 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:
95991-4121
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-755-0856
Provider Business Practice Location Address Fax Number:
530-755-0858
Provider Enumeration Date:
11/21/2005