Provider First Line Business Practice Location Address:
310 HEMSTED DR
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-0935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-221-0726
Provider Business Practice Location Address Fax Number:
530-221-0137
Provider Enumeration Date:
03/01/2012