Provider First Line Business Practice Location Address:
384 HARTNELL 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:
96002-1884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-223-3400
Provider Business Practice Location Address Fax Number:
530-223-9035
Provider Enumeration Date:
03/22/2007