Provider First Line Business Practice Location Address:
4040 SAINT PATRICKS AVE
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:
96003-1806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-712-4202
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2007