Provider First Line Business Practice Location Address:
2624 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:
96001-3092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-241-3316
Provider Business Practice Location Address Fax Number:
530-241-6319
Provider Enumeration Date:
03/06/2014