Provider First Line Business Practice Location Address:
1245 THARP RD STE B
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:
95993-2647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-300-4421
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/22/2025