Provider First Line Business Practice Location Address:
2060 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-2373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-527-2147
Provider Business Practice Location Address Fax Number:
530-527-2410
Provider Enumeration Date:
10/13/2006