Provider First Line Business Practice Location Address:
710 PLUMAS AVE APT 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OROVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95965-3247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-744-5077
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/15/2025