| NPI | 1457801417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY LEE WILSON Owner 530-945-2192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA MFC43963) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |