Provider First Line Business Practice Location Address:
485 ANTELOPE BLVD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
RED BLUFF
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96080-2444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-527-1774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2006