Provider First Line Business Practice Location Address:
2143 CARTAGENA DR
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:
95993-5307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-755-2157
Provider Business Practice Location Address Fax Number:
530-755-2299
Provider Enumeration Date:
10/06/2009