Provider First Line Business Practice Location Address:
12450 MARIA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-436-9000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/11/2006