Provider First Line Business Practice Location Address:
1555 EAST ST
Provider Second Line Business Practice Location Address:
STE 220
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-246-1243
Provider Business Practice Location Address Fax Number:
530-247-8202
Provider Enumeration Date:
11/21/2006