Provider First Line Business Practice Location Address:
375 SMILE PL
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:
96001-3637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-243-6548
Provider Business Practice Location Address Fax Number:
530-243-9470
Provider Enumeration Date:
09/26/2006