Provider First Line Business Practice Location Address:
2662 EDITH 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:
96001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-242-1266
Provider Business Practice Location Address Fax Number:
530-243-4205
Provider Enumeration Date:
12/13/2006