Provider First Line Business Practice Location Address:
3305 PLACER ST
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-3687
Provider Business Practice Location Address Fax Number:
530-243-3383
Provider Enumeration Date:
12/01/2005