Provider First Line Business Practice Location Address:
3328 CHURN CREEK RD
Provider Second Line Business Practice Location Address:
#A
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-688-6178
Provider Business Practice Location Address Fax Number:
805-688-9236
Provider Enumeration Date:
05/03/2007