Provider First Line Business Practice Location Address:
1766 CALIFORNIA ST
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:
96001-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-242-1511
Provider Business Practice Location Address Fax Number:
530-242-1611
Provider Enumeration Date:
09/23/2010