Provider First Line Business Practice Location Address:
1119 HIGH ST STE 2
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:
95603-5153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-537-2279
Provider Business Practice Location Address Fax Number:
530-537-2279
Provider Enumeration Date:
09/06/2019