Provider First Line Business Practice Location Address:
1153 BUTTE HOUSE RD
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:
95991-3102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-671-1828
Provider Business Practice Location Address Fax Number:
530-671-1828
Provider Enumeration Date:
06/20/2012