Provider First Line Business Practice Location Address:
2525 VICTOR AVE,
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96002-1465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-222-2284
Provider Business Practice Location Address Fax Number:
530-222-2648
Provider Enumeration Date:
12/28/2006