Provider First Line Business Practice Location Address:
2175 ROSALINE 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:
96001-2549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-340-5467
Provider Business Practice Location Address Fax Number:
530-247-3446
Provider Enumeration Date:
03/23/2007