Provider First Line Business Practice Location Address:
3689 EUREKA WAY
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:
96001-0177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-247-4211
Provider Business Practice Location Address Fax Number:
530-247-4241
Provider Enumeration Date:
10/09/2006