Provider First Line Business Practice Location Address:
2299 RIVER OAKS BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLUMAS LAKE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-772-5801
Provider Business Practice Location Address Fax Number:
530-772-5807
Provider Enumeration Date:
05/29/2025